Indocyanine Green and Near-Infrared Fluorescence Imaging in Gastric Cancer Precision Surgical Approach

Sakamoto, Erica; Dias, André Roncon; Ramos, Marcus Fernando Kodama Pertille; Safatle‐Ribeiro, Adriana Vaz; Zilberstein, Bruno; Ribeiro, Ulysses

doi:10.1590/s0004-2803.202100000-100

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…Fluorescence imaging technology has been widely applied in surgery. [8][9][10][11][12][13] ICG fluorescence imaging application for LLND has been reported since 2016. [24][25][26][27][28] Zhou et al 25 revealed that the ICG group had significantly lower intraoperative blood loss and a larger number of harvested LLNs compared to that in the non-ICG group.…”

Section: Discussionmentioning

confidence: 99%

“…The NIR fluorescence emitted from ICG helps in making surgical decisions, with high sensitivity, strong specificity, and better imaging depth of penetration. [8][9][10][11][12][13] Lymph node detection rate improves significantly in laparoscopic GI surgery under NIR imaging. Lymph nodes and lymphatic vessels can be distinguished after submucosal injection of ICG, and this practical method is currently becoming a new direction of exploration to accurately perform lymph node dissection within the specified range.…”

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confidence: 99%

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Applications of Near-Infrared Fluorescence Imaging and Angiography of Inferior Vesical Artery in Laparoscopic Lateral Lymph Node Dissection: A Prospective Nonrandomized Controlled Study

Tang,

Zhou,

et al. 2023

Diseases of the Colon &Amp; Rectum

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BACKGROUND: Near-infrared imaging with indocyanine green has been used to guide lateral lymph node dissection, yet its efficacy and benefits need further investigation. OBJECTIVE: To investigate the efficacy and feasibility of near-infrared fluorescence imaging and angiography of inferior vesical artery in laparoscopic lateral lymph node dissection. DESIGN: A prospective non-randomized controlled study. SETTINGS: Single center study PATIENTS: Patients with lower rectal cancer who underwent total mesorectal excision plus lateral lymph node dissection. MAIN OUTCOME MEASURES: A cohort of 108 patients was enrolled. After propensity score matching, 29 patients in near-infrared group and 50 patients in non-near-infrared group were matched. The total number of harvested lateral lymph nodes, positive lateral lymph nodes, inferior vesical artery preservation, and postoperative urinary function were compared. RESULTS: After propensity score matching, the baseline characteristics were similar in both groups. The total number of harvested lateral lymph nodes in the near-infrared group was significantly higher (12 vs 9, p = 0.013), but positive lateral lymph nodes were similar between the two groups (1 vs. 1, p = 0.439). The ratio of inferior vesical artery preservation was significantly increased with the aid of indocyanine green angiography (93.1% vs. 56.0%, p < 0.001). The non-near-infrared group required more days for urinary catheter removal than the near-infrared group (5 vs. 4, p = 0.046). Urinary recatheterization tended to occur more frequently in the non-near-infrared group, with a marginally significant trend (16% vs. 0%, p = 0.059). The non-near-infrared group tended to have more cases with residual urine volume ≥50 ml than that of the near-infrared group (20.0% vs. 3.4%, p = 0.087), especially in the bilateral dissection subgroup (41.2% vs. 0%, p = 0.041). LIMITATIONS: Small sample size. CONCLUSIONS: Near-infrared imaging increased the number of harvested lateral lymph nodes, while real-time indocyanine green fluorescence angiography ensured the preservation of inferior vesical artery and tended to improve postoperative urinary function.

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