Dual-time-point ICGA for perfusion-guided transaxillary single-port endoscopic gynecomastia surgery: a prospective exploratory comparative cohort study.

Wang C, Jiang H, Zhang X, Miao X, Zhao F, Liu X, Dang X.

Journal ArticleAbstract only — full text under license

AI summary — for doctors, generated from the abstract only

Indocyanine green perfusion angiography in endoscopic gynecomastia surgery was linked to fewer early perfusion-related tissue changes.

What was studied

Prospective exploratory cohort of 88 men (43 with ICGA, 45 without).

Key findings

Primary endpoint 7.0% (3/43) vs 26.7% (12/45), OR 0.21 (95% CI 0.05 to 0.79)
Absolute risk difference -19.7 percentage points
26% relative perfusion value was an exploratory warning threshold

Clinical relevance

May help guide intraoperative decisions.

Who should care

General SurgeryEndocrine Surgery

Limitations

Small, non-randomized, single-center; threshold exploratory.

Encouraging, needs validation.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Background

This study evaluated a standardized dual-time-point indocyanine green fluorescence angiography (ICGA) protocol in transaxillary single-port endoscopic surgery for gynecomastia, focusing on early perfusion-related outcomes, perioperative recovery, and patient-reported outcomes.

Methods

This prospective exploratory comparative cohort study included 88 men undergoing transaxillary single-port endoscopic subcutaneous glandular excision. Forty-three patients received ICGA and 45 did not. In the ICGA group, perfusion was assessed after deep dissection from the pectoralis major fascia and again after skin closure before compression dressing. Perfusion grading guided intraoperative adjustment and postoperative risk-stratified management. The primary outcome was a perfusion-related composite endpoint within 14 postoperative days. Secondary outcomes included perioperative variables, early complications, nipple sensation change, and 6-month BODY-Q scores. An exploratory observation point analysis assessed the association between second ICGA relative perfusion value (RPV) and postoperative day 14 local tissue changes.

Results

The primary endpoint occurred in 3 of 43 patients (7.0%) in the ICGA group and 12 of 45 patients (26.7%) in the non-ICGA group, corresponding to an absolute risk difference of - 19.7 percentage points (95% confidence interval, - 34.8 to - 3.9) and an odds ratio of 0.21 (95% confidence interval, 0.05 to 0.79; P = 0.022). Perioperative recovery variables did not differ significantly. At 6 months, adjusted satisfaction with chest and nipples was higher in the ICGA group, whereas scar appraisal and psychological function showed no clear between-group differences. Lower second ICGA RPV was associated with postoperative day 14 local residual risk tissue changes, with 26.0% identified as an exploratory warning threshold.

Conclusions

A standardized dual-time-point ICGA protocol was feasible and was associated with fewer early perfusion-related tissue changes without evident perioperative burden. The 26% RPV value remains an exploratory warning signal requiring external validation.

DOI

10.1007/s00464-026-13451-8

PMID

42855512

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

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