Gastric cancer indocyanine green lymph node navigation surgery: systematic review

Molteni, Beatrice; Porsio, Paola; Molfino, Sarah; Alfano, Marie Sophie; Benedicenti, Sara; Catena, Fausto; Ansaloni, Luca; Portolani, Nazario; Baiocchi, Gian Luca

doi:10.4081/joper.2018.97

Cited by 4 publications

(1 citation statement)

References 2 publications

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“…In the field of gastric cancer surgery, the NIR/ICG technology was firstly applied in Eastern countries for sentinel LN detection in patients with early gastric cancer (EGC) ( 19 ). In Western countries, where the different tumor biology and the absence of a screening program lead to a higher rate of ACG with nodal involvement at first diagnosis ( 20 ), the NIR/ICG technology was rather used for abdominal nodal mapping ( 21 , 22 ) showing promising results in the assessment of lymphadenectomy thoroughness ( 23 – 26 ). However, all the studies investigating NIR/ICG technology focused on its ability to increase the number of harvested LNs, while no data exist regarding its potential role in changing the surgical conduct at the moment of lymphadenectomy ( 27 ) allowing an improvement in lymphadenectomy as compared with lymphadenectomy performed without the use of any technology; in addition, no data exist about the role of this hypothetical lymphadenectomy improvement on tumor staging and the subsequent treatment planning.…”

Section: Introductionmentioning

confidence: 99%

The iGreenGO Study: The Clinical Role of Indocyanine Green Imaging Fluorescence in Modifying the Surgeon’s Conduct During the Surgical Treatment of Advanced Gastric Cancer—Study Protocol for an International Multicenter Prospective Study

et al. 2022

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BackgroundThe near-infrared/indocyanine green imaging fluorescence (NIR/ICG) technology is showing promising results in several fields of surgical oncology. The clinical value of NIR/ICG technology in the surgical treatment of advanced gastric cancer (AGC) is not clearly established.MethodsThis is the protocol of the “iGreenGO” (indocyanine Green Gastric Observation) Study, a national prospective multicenter study. Western patients who undergo curative-intent gastrectomy with D2 lymphadenectomy for AGC constitute the study cohort. All the patients undergo preoperative upper gastrointestinal endoscopy for submucosal peritumoral ICG injection at the most 20 h before surgery. Intraoperative endoscopic injection before starting surgical dissection is also allowed. The primary endpoint is the “change in the surgical conduct” (CSC), i.e., the need to perform further dissection after intraoperative NIR/ICG technology activation at the end of D2 lymphadenectomy. Secondary endpoints include the pattern of abdominal fluorescence distribution according to tumor and patient characteristics, the preoperative clinical variables potentially associated with CSC, and the incidence of stage migration due to NIR/ICG application.DiscussionThe iGreenGO Study is the first study to investigate the clinical role of NIR/ICG technology for the surgical treatment of AGC in a large cohort of Western patients. Results from the present study can further clarify the role of NIR/ICG technology in surgical lymphadenectomy for AGC.

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Section: Introductionmentioning

confidence: 99%

The iGreenGO Study: The Clinical Role of Indocyanine Green Imaging Fluorescence in Modifying the Surgeon’s Conduct During the Surgical Treatment of Advanced Gastric Cancer—Study Protocol for an International Multicenter Prospective Study

et al. 2022

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Laparoscopic Distal Gastrectomy and Indocyanine Green Fluorescence-Guided Lymphadenectomy

Molfino

Baiocchi

2021

Gastric Cancer: The 25-Year R-Evolution

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Could fluorescence-guided surgery be an efficient and sustainable option? A SICE (Italian Society of Endoscopic Surgery) health technology assessment summary

et al. 2020

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Background Indocyanine green fluorescence vision is an upcoming technology in surgery. It can be used in three ways: angiographic and biliary tree visualization and lymphatic spreading studies. The present paper shows the most outstanding results from an health technology assessment study design, conducted on fluorescence-guided compared with standard vision surgery. Methods A health technology assessment approach was implemented to investigate the economic, social, ethical, and organizational implications related to the adoption of the innovative fluorescence-guided view, with a focus on minimally invasive approach. With the support of a multidisciplinary team, qualitative and quantitative data were collected, by means of literature evidence, validated questionnaires and self-reported interviews, considering the dimensions resulting from the EUnetHTA Core Model. Results From a systematic search of literature, we retrieved the following studies: 6 on hepatic, 1 on pancreatic, 4 on biliary, 2 on bariatric, 4 on endocrine, 2 on thoracic, 11 on colorectal, 7 on urology, 11 on gynecology, 2 on gastric surgery. Fluorescence guide has shown advantages on the length of hospitalization particularly in colorectal surgery, with a reduction of the rate of leakages and re-do anastomoses, in spite of a slight increase in operating time, and is confirmed to be a safe, efficacious, and sustainable vision technology. Clinical applications are still presenting a low evidence in the literature. ConclusionThe present paper, under the patronage of Italian Society of Endoscopic Surgery, based on an HTA approach, sustains the use of fluorescence-guided vision in minimally invasive surgery, in the fields of general, gynecologic, urologic, and thoracic surgery, as an efficient and economically sustainable technology.

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Gastric cancer indocyanine green lymph node navigation surgery: systematic review

Cited by 4 publications

References 2 publications

The iGreenGO Study: The Clinical Role of Indocyanine Green Imaging Fluorescence in Modifying the Surgeon’s Conduct During the Surgical Treatment of Advanced Gastric Cancer—Study Protocol for an International Multicenter Prospective Study

The iGreenGO Study: The Clinical Role of Indocyanine Green Imaging Fluorescence in Modifying the Surgeon’s Conduct During the Surgical Treatment of Advanced Gastric Cancer—Study Protocol for an International Multicenter Prospective Study

Laparoscopic Distal Gastrectomy and Indocyanine Green Fluorescence-Guided Lymphadenectomy

Could fluorescence-guided surgery be an efficient and sustainable option? A SICE (Italian Society of Endoscopic Surgery) health technology assessment summary

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