Applicative Limitations of Indocyanine Green Fluorescence Assistance to Laparoscopic Lymph Node Dissection in Total Gastrectomy for Cancer

Puccetti, Francesco; Cinelli, Lorenzo; Genova, Luana; Battaglia, Silvia; Barbieri, Lavinia; Treppiedi, Elio; Cossu, Andrea; Elmore, Ugo; Rosati, Riccardo

doi:10.1245/s10434-022-11940-3

Cited by 16 publications

(8 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The safety and feasibility of ICG-NIR imaging-guided lymphadenectomy were also confirmed in patients with oesophageal cancer, as described in a previous study by Hachey et al ( 6 ). Puccetti, F et al ( 24 ) reported that the use of neoadjuvant radiotherapy had no significant effect on the percentage of ICG + lymph node in the treatment of gastric cancer. And Zhang, L et al ( 25 ) also reported that neoadjuvant radiotherapy had no effect on the percentage of ICG + lymph node in breast cancer treatment.…”

Section: Discussionmentioning

confidence: 99%

Indocyanine green near-infrared imaging-guided lymph node dissection during oesophageal cancer surgery: A single-centre experience

Chen

Tian

et al. 2023

Front. Surg.

View full text Add to dashboard Cite

ObjectiveThis study aimed to investigate the feasibility of using indocyanine green (ICG) near-infrared (NIR) imaging during lymphadenectomy for oesophageal cancer.MethodsEighty-seven patients with primary oesophageal cancer were enrolled in this study. All the enrolled patients received an endoscopic injection of ICG between 40 min and 23 h before surgery. Nodal dissection during surgery was performed under fluorescence imaging visualisation, with the NIR signal shown in purple. ICG+ or ICG− nodes were recorded station by station and were microscopically evaluated.ResultsEndoscopic peritumoral ICG injection was successfully performed in all patients. Major post-surgery complications included wound infection, pleural effusion, dysphonia, pneumonia and anastomotic fistula. No patients experienced ICG-related adverse events. A total of 2,584 lymph nodes were removed, and the mean number of lymph nodes for each patient was 29.70 ± 9.24. Most of the removed nodes (97.83%) were ICG+, and 3.32% of the ICG+ nodes were metastatic. No metastatic nodes were ICG− or belonged to an ICG− lymph node station. The time from ICG injection to surgery did not affect the number of harvested lymph nodes.ConclusionsThe use of ICG-NIR imaging during oesophageal cancer surgery can enhance the visualisation of lymph nodes during surgery. It is a feasible, safe and helpful technique for lymphadenectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

Indocyanine green near-infrared imaging-guided lymph node dissection during oesophageal cancer surgery: A single-centre experience

Chen

Tian

et al. 2023

Front. Surg.

View full text Add to dashboard Cite

show abstract

“…Many studies have demonstrated that ICG-guided LNs clearance is useful to improve the detection rate of LNs ( 67 , 68 , 70 ), but it remains unclear whether ICG-FI can detect all potentially metastatic LNs and accurately guide LNs clearance. In a study by Zhong et al , the mean (SD) number of LNs that were ultimately retrieved in the ICG group was 49.9 (14.8), which was more than the number retrieved in the non-ICG group [42.0 (10.3)].…”

Section: Discussionmentioning

confidence: 99%

A narrative review of intraoperative use of indocyanine green fluorescence imaging in gastrointestinal cancer: situation and future directions

Li¹,

Xie²,

Du³

et al. 2023

J Gastrointest Oncol

View full text Add to dashboard Cite

Background and Objective: As a surgical tool, indocyanine green (ICG) is increasingly used in surgery, especially in gastric and colorectal surgery. The use of ICG fluorescence imaging can improve the accuracy of tumor resection and potentially improve surgical outcomes for cancer patients. However, there are still different opinions or controversies on the application of ICG in the literature and the administration of ICG is still not uniform. In this review, we summarize the current status of its application and ICG administration methods in gastrointestinal cancer and discuss its existing limitations and future research directions.Methods: Literature published in the PubMed database from 1969 to 2022 was searched for using the keywords "Indocyanine green or near-infrared imaging or ICG", "gastric cancer", "gastroesophageal junction cancer", and "colorectal cancer" to summarize the main applications of ICG in gastrointestinal cancers.

show abstract

“…Even if produced scarring after endoscopic submucosal dissection, the use of ICG still yielded positive effects [ 66 ]. However, it remains controversial whether ICG can benefit LN dissection after neoadjuvant chemotherapy-induced local histological changes [ 3 , 69 ]. Since fluorescence can be quantitatively analyzed to reduce human subjective error, research has been carried out to determine appropriate fluorescence values for SLN detection [ 82 ].…”

Section: Tracers In Gc Surgerymentioning

confidence: 99%

“…Only the Chinese clinical guidelines mention the possible application prospects of tracers [ 134 ]. Based on data from several clinical studies, we can only roughly conclude that excessive fat, preoperative chemotherapy, and advanced tumor staging seem to be unfavorable to the functions of tracers [ 3 , 25 , 51 , 111 ]. Numerous limitations remain to be addressed.…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

“…The most critical issues in radical GC surgery are thorough lymph node dissection and the determination of surgical margins [ 2 ]. Suitable acquisition of LNs is significantly connected to pathological staging and prognosis [ 3 , 4 ]. However, for most patients with early GC without LN metastases, biopsy of sentinel lymph nodes (SLNs) for the detection of metastases to determine extended or limited resection appears to be the most appropriate option [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tracers in Gastric Cancer Surgery

Zhu

et al. 2022

Cancers

View full text Add to dashboard Cite

The treatment of gastric cancer mainly depends on radical gastrectomy. Determination of appropriate surgical margins and adequate lymph node (LN) resection are two major surgical steps that directly correlate with prognosis in gastric cancer. Due to the expanding use of minimally invasive procedures, it is no longer possible to locate tumors and LNs through touch. As an alternative, tracers have begun to enter the field due to their capacities for intraoperative visualization. Herein, we summarize the application of contemporary tracers in gastric cancer surgery, including isosulfan blue, methylene blue, patent blue, indocyanine green, carbon particles, and radioactive tracers. Their mechanisms, administration methods, detection efficiency, and challenges, as well as perspectives on them, are also outlined.

show abstract

Applicative Limitations of Indocyanine Green Fluorescence Assistance to Laparoscopic Lymph Node Dissection in Total Gastrectomy for Cancer

Cited by 16 publications

References 37 publications

Indocyanine green near-infrared imaging-guided lymph node dissection during oesophageal cancer surgery: A single-centre experience

Indocyanine green near-infrared imaging-guided lymph node dissection during oesophageal cancer surgery: A single-centre experience

A narrative review of intraoperative use of indocyanine green fluorescence imaging in gastrointestinal cancer: situation and future directions

Tracers in Gastric Cancer Surgery

Contact Info

Product

Resources

About