Fluoreszenzgesteuerte Detektion von Lymphknotenmetastasen bei gastrointestinalen Tumoren

Picchetto, Andrea; Seeliger, Barbara; Rocca, Stefania La; Barberio, Manuel; D’Ambrosio, Giancarlo; Marescaux, Jacques; Diana, Michèle

doi:10.1007/s00104-019-01039-z

Cited by 7 publications

(3 citation statements)

References 64 publications

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“…As reported by several authors, the first one to four nodes that became fluorescent in the first 15 min were identified as SLNs, were dissected free from the mesocolon or mesorectum (Figure 3), and were labelled and sent to the pathologist [9,18,26]. The remaining intact specimen was further investigated as usual (without NIRF) by the pathologist to retrieve the other lymph nodes and perform the anatomopathological staging.…”

Section: Methodsmentioning

confidence: 99%

“…SLN mapping in CRC was initially suggested by Saha et al during the 50th annual cancer symposium of the Society of Surgical Oncology in 1997. It has since been described by various authors as having favorable but inconstant outcomes and accuracy rates, mainly due to the diversity of the mapping methods which were scrutinized [14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Upstaging nodal status in colorectal cancer using ex vivo fluorescence sentinel lymph node mapping: preliminary results

Picchetto

Diana

Swanström

et al. 2020

Minimally Invasive Therapy & Allied Technologies

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Background: Sentinel lymph node (SLN) mapping using near-infrared fluorescence (NIRF) imaging is a recent technique to improve nodal staging in several tumors. The presence of colorectal cancer (CRC) micro-metastases has recently been defined as N1 disease and no longer as N1mi, determining the need for adjuvant chemotherapy. In CRC, the reported rate of SLN micro-metastases detected by ultrastaging techniques is as high as 30%. The aim of this prospective study is to report the preliminary results of the sensitivity analysis of NIRF imaging for ex vivo SLN mapping and the research of micro-metastases in CRC, in patients with node-negative disease (NND). Material and methods: On the specimen of 22 CRC patients, 1 mL of ICG (5 mg/mL) was injected submucosally around the tumor to identify SLNs. NND SLNs were further investigated with ultrastaging techniques. Results: Three-hundred and sixty-three lymph nodes were retrieved (59 SLNs; mean per case: 2.7). The detection, sensitivity and false-negative rate were 100%, 100% and 0% respectively. Ultrastaging investigations showed no micro-metastases in the NND SLNs. Conclusions: The ex vivo SLN fluorescence-based detection in CRC was confirmed to be easy to perform and reliable. In this preliminary results report of an ongoing study, the SLN assay was congruent with the nodal status, as confirmed by histological investigations.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Upstaging nodal status in colorectal cancer using ex vivo fluorescence sentinel lymph node mapping: preliminary results

Picchetto

Diana

Swanström

et al. 2020

Minimally Invasive Therapy & Allied Technologies

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“…Interest and studies evaluating the utility of intraoperative near-infrared fluorescence imaging (NIRFI) in general surgery disciplines has grown dramatically over the last decade. 1,2 For general surgeons, indocyanine green (ICG) NIRFI has increasingly been utilized for a variety of roles including biliary mapping, [3][4][5][6][7] evaluation of anastomotic perfusion, [8][9][10][11][12] and identification of hepatic tumor margins, 13,14 localization of metastatic disease 13,15 and lymph nodes, 13,[16][17][18][19][20] characterization of vascular anatomy, 21,22 and ureteric identification. 13,23,24 Studies evaluating these techniques and their optimal implementation are ongoing.…”

Section: Introductionmentioning

confidence: 99%

Characterization of Near-Infrared Imaging and Indocyanine-Green Use Amongst General Surgeons: A Survey of 263 General Surgeons

et al. 2022

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Background Near-infrared fluorescence imaging (NIRFI) is an increasingly utilized imaging modality, however its use amongst general surgeons and its barriers to adoption have not yet been characterized. Methods This survey was sent to Canadian Association of General Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons members. Survey development occurred through consensus of NIRFI experienced surgeons. Results Survey completion rate for those opening the email was 16.0% (n = 263). Most respondents had used NIRFI (n = 161, 61.2%). Training, higher volumes, and bariatric, thoracic, or foregut subspecialty were associated with use (P < .001). Common reasons for NIRFI included anastomotic assessment (n = 117, 72.7%), cholangiography (n = 106, 65.8%), macroscopic angiography (n = 66, 41.0%), and bowel viability assessment (n = 101, 62.7%). Technical knowledge, training and poor evidence were cited as common barriers to NIRFI adoption. Conclusions NIRFI use is common with high case volume, bariatric, foregut, and thoracic surgery practices associated with adoption. Barriers to use appear to be lack of awareness, low confidence in current evidence, and inadequate training. High quality randomized studies evaluating NIRFI are needed to improve confidence in current evidence; if deemed beneficial, training will be imperative for NIRFI adoption.

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Evidenz der Indocyaningrünfluoreszenz in der robotisch assistierten Kolorektalchirurgie

Vilz¹,

Kalff²,

Stoffels

2021

Chirurg

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Evidenz der Indocyaningrünfluoreszenz in der robotisch assistierten Kolorektalchirurgie Wie ist der Status? Organe und Gewebetypen sind in Lehrbüchern und anatomischen Atlanten verschieden farblich gekennzeichnet (z. B. Arterien rot, Venen blau, Nerven gelb), die Realität stellt sich jedoch anders dar. Indocyaningrün(ICG)-Fluoreszenz ermöglicht es, anatomische Strukturen (Gefäße, Lymphknoten) neongrün leuchten zu lassen, und kann so die exakte Präparationsebene anzeigen. Farbkodierte Operationen sind durch moderne Technik (Laserfluoreszenz) plus Präzisionschirurgie (Robotik) heutzutage zunehmend Standard. Durch Lektüre dieses Beitrags erhalten Sie eine aktuelle, kritische Zusammenstellung fundiertenHintergrundwissens relevanter wissenschaftlicher Ergebnisse zum Einsatz von ICG-Fluoreszenz und einen Ausblick auf zukünftige Entwicklungen durch Applikation von Fluoreszenzfarbstoffen in der robotisch assistierten Kolorektalchirurgie.

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Fluoreszenzgesteuerte Detektion von Lymphknotenmetastasen bei gastrointestinalen Tumoren

Cited by 7 publications

References 64 publications

Upstaging nodal status in colorectal cancer using ex vivo fluorescence sentinel lymph node mapping: preliminary results

Upstaging nodal status in colorectal cancer using ex vivo fluorescence sentinel lymph node mapping: preliminary results

Characterization of Near-Infrared Imaging and Indocyanine-Green Use Amongst General Surgeons: A Survey of 263 General Surgeons

Evidenz der Indocyaningrünfluoreszenz in der robotisch assistierten Kolorektalchirurgie

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