Fluorescence-guided nodal navigation during colectomy for colorectal cancer

Caprioli, Michela; Garosio, I.; Botteri, Emanuele; Vettoretto, Nereo; Molteni, Beatrice; Molfino, Sarah; Yiu, Daniel; Portolani, Nazario; Baiocchi, Gian Luca

doi:10.1080/13645706.2022.2045500

Cited by 8 publications

(8 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most importantly, they reported a change in the extent of mesenteric resection and vessel ligation in 23.5% of patients. Similar results are reported in later studies [ 54 , 60 , 61 , 62 ]. Along with the feasibility of the intraoperative ICG imaging of lymphovascular drainage in colorectal cancer, a later study by Chand et al [ 63 ] also showed that the success of lymphatic imaging was affected by the quantity of ICG injected into the bowel wall and that India ink tattooing that could potentially block lymph drainage and cause inflammatory phenomena.…”

Section: Current Uses Of Icg In Colorectal Surgerysupporting

confidence: 92%

Indocyanine Green Fluorescence Guided Surgery in Colorectal Surgery

Garoufalia

Wexner

2023

JCM

View full text Add to dashboard Cite

Background: Indocyanine green (ICG) imaging has been increasingly used for intraoperative guidance in colorectal surgery over the past decade. The aim of this study was to review and organize, according to different type of use, all available literature on ICG guided colorectal surgery and highlight areas in need of further research and discuss future perspectives. Methods: PubMed, Scopus, and Google Scholar databases were searched systematically through November 2022 for all available studies on fluorescence-guided surgery in colorectal surgery. Results: Available studies described ICG use in colorectal surgery for perfusion assessment, ureteral and urethral assessment, lymphatic mapping, and hepatic and peritoneal metastases assessment. Although the level of evidence is low, results are promising, especially in the role of ICG in reducing anastomotic leaks. Conclusions: ICG imaging is a safe and relatively cheap imaging modality in colorectal surgery, especially for perfusion assessment. Work is underway regarding its use in lymphatic mapping, ureter identification, and the assessment of intraperitoneal metastatic disease.

show abstract

Section: Current Uses Of Icg In Colorectal Surgerysupporting

confidence: 92%

Indocyanine Green Fluorescence Guided Surgery in Colorectal Surgery

Garoufalia

Wexner

2023

JCM

View full text Add to dashboard Cite

show abstract

“…Data on the tracer application site were retrievable from 35 studies, while two cohorts [ 12 , 28 ] were distributed to both groups. Studies not specifying the application site were excluded from this analysis.…”

Section: Resultsmentioning

confidence: 99%

“…All individual patient data (IPD) available from the included studies were further analyzed according to factors influencing the effectiveness of LN mapping and aberrant LN detection. Data on tumor characteristics, the timing, and the tracer application site from ten studies could be extracted and included in this analysis [ 12 , 16 , 17 , 28 , 29 , 31 , 32 , 159 , 174 , 190 ]. Studies neither searching nor resecting aberrant LNs or not reporting the mapped LN yield did not contribute to the respective analysis.…”

Section: Resultsmentioning

confidence: 99%

“…All searches were conducted on 20 July 2021; the original search string can be found in the Supplementary Data (Data S1) . A second search using the same search strategies was conducted on 13 February 2023, which led to five newly published studies [ 28 , 29 , 30 , 31 , 32 ]. Reviews [ 8 , 9 , 10 , 11 , 12 , 33 , 34 ] concerning similar research topics were manually searched for possible missed publications.…”

Section: Methodsmentioning

confidence: 99%

“…The pooled estimate of the proportion of traced LNs is 14.3%. CI—confidence interval; ES—effect size; ICG—indocyanine green [ 12 , 16 , 19 , 25 , 26 , 28 , 32 , 35 , 157 , 158 , 159 , 162 , 163 , 165 , 168 , 169 , 170 , 171 , 174 , 175 , 176 , 178 , 179 , 180 , 181 , 182 , 183 , 187 , 188 , 190 , 192 , 193 , 194 , 195 , 197 ].…”

Section: Figurementioning

confidence: 99%

See 2 more Smart Citations

Lymphatic Mapping in Colon Cancer Depending on Injection Time and Tracing Agent: A Systematic Review and Meta-Analysis of Prospective Designed Studies

Lucas

Melling

Giannou

et al. 2023

Cancers

View full text Add to dashboard Cite

An optimized lymph node yield leads to better survival in colon cancer, but extended lymphadenectomy is not associated with survival benefits. Lymphatic mapping shows several colon cancers feature aberrant drainage pathways inducing local recurrence when not resected. Currently, different protocols exist for lymphatic mapping procedures. This meta-analysis assessed which protocol has the best capacity to detect tumor-draining and possibly metastatic lymph nodes. A systematic review was conducted according to PRISMA guidelines, including prospective trials with in vivo tracer application. The risk of bias was evaluated using the QUADAS-2 tool. Traced lymph nodes, total resected lymph nodes, and aberrant drainage detection rate were analyzed. Fifty-eight studies met the inclusion criteria, of which 42 searched for aberrant drainage. While a preoperative tracer injection significantly increased the traced lymph node rates compared to intraoperative tracing (30.1% (15.4, 47.3) vs. 14.1% (11.9, 16.5), p = 0.03), no effect was shown for the tracer used (p = 0.740) or the application sites comparing submucosal and subserosal injection (22.9% (14.1, 33.1) vs. 14.3% (12.1, 16.8), p = 0.07). Preoperative tracer injection resulted in a significantly higher rate of detected aberrant lymph nodes compared to intraoperative injection (26.3% [95% CI 11.5, 44.0] vs. 2.5% [95% CI 0.8, 4.7], p < 0.001). Analyzing 112 individual patient datasets from eight studies revealed a significant impact on aberrant drainage detection for injection timing, favoring preoperative over intraoperative injection (OR 0.050 [95% CI 0.010–0.176], p < 0.001) while indocyanine green presented itself as the superior tracer (OR 0.127 [95% CI 0.018–0.528], p = 0.012). Optimized lymphatic mapping techniques result in significantly higher detection of aberrant lymphatic drainage patterns and thus enable a personalized approach to reducing local recurrence.

show abstract