ISSN: 1859 - 2872
The results of Laparoscopic gastrectomy with D2 lymphadenectomy using Indocyanine Green for radical gastric adenocarcinoma
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Abstract
Objective: To evaluate the outcomes of laparoscopic gastrectomy with D2 lymphadenectomy using Indocyanine Green (ICG) in the treatment of gastric adenocarcinoma. Subject and method: A prospective descriptive study was conducted at the 108 Military Central Hospital from August 2021 to December 2024. Patients received submucosal endoscopic injections of ICG on the day before surgery. During the operation, a fluorescence imaging system was employed to guide standard D2 lymphadenectomy. Result: A total of 81 patients underwent laparoscopic subtotal gastrectomy with D2 lymphadenectomy guided by ICG fluorescence imaging. The pathological tumor stages in the cohort were pT1 (36%), pT2 (27%), pT3 (20%), and pT4a (17%). Lymph node metastasis was observed in 35.8% of patients. The mean distance from the proximal resection margin to the tumor was 5.5 ± 1.9 cm, with negative histological results for both proximal and distal margins in all cases. No cases required conversion to open surgery. The mean time to gastrointestinal recovery was 3.1 days, and the average postoperative hospital stay was 7.9 ± 2.1 days. Early postoperative complications were observed in 11.1% of cases. Postoperative recurrence occurred in 9 patients (11.1%). The mean follow-up periods for overall survival (OS) and disease-free survival (DFS) were 25.5 ± 8.2 and 24.4 ± 8.5 months, respectively. The estimated 3-year OS rate was 82.7%. The 2-year and 3-year OS rates for stage II patients were 100% and 88.9%, respectively, and for stage III patients, they were 83.6% and 46.4%, respectively. Conclusion: Laparoscopic gastrectomy with D2 lymphadenectomy using ICG for gastric adenocarcinoma treatment is a safe surgical method associated with a low rate of complications.
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References
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