ISSN: 1859 - 2872
Assessment of the effectiveness of Indocyanine Green fluorescent lymphography guided lymphadenectomy in laparoscopic radical gastrectomy for gastric cancer
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Abstract
Objective: To investigate efficacy of Indocyanine Green (ICG) near-infrared tracer-guided imaging during laparoscopic lymphadenectomy for gastric cancer. Subject and method: A cross-sectional study, Patients with clinical T1–T4a gastric cancer were included at 108 Military Central Hospital from 8/2021 to 8/2022. ICG was peritumorally injected the day prior to surgery by endoscopy. Laparoscopic Gastrectomy with systematic D2 lymphadenectomy was performed. Lymph nodes (LNs) were retrieved using near-infrared imaging and classified as “fluorescent” or “non-fluorescent”. Result: In total, 29 patients underwent fluorescent lymphography-guided lymphadenectomy. Early gastric cancer was diagnosed postoperatively in 10 of 29 (34.5%) patients. A total of 1130 LNs were retrieved, of theses, the number fluorescent Lymph nodes was 1005 LNs (88.9%), and non-fluorescent was 125 LNs (11.1%). The median number of retrieved LNs per patient was 38.9 ± 12.3 LNs including 34.6 ± 11.7 fluorescent LNs. Lymph Node metastases were detected in 12 (44.4%) patients, while no LN metastases were detected in the remaining 17 (58.6%) patients. Conclusion: Indocyanine green fluorescence imaging can be performed for routine lymphatic mapping during laparoscopic gastrectomy and improve the number of lymph node dissections.
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References
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