Application of Near-Infrared Fluorescence Imaging with Indocyanine Green in Totally Laparoscopic Distal Gastrectomy

Maoxing Liu; Jiadi Xing; Kai Xu; Peng Yuan; Ming Cui; Chenghai Zhang; Hong Yang; Zhendan Yao; Nan Zhang; Fei Tan; Xiangqian Su

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자료유형: 학술저널

저자정보: Maoxing Liu (Peking University Cancer Hospital & Institute) Jiadi Xing (Peking University Cancer Hospital & Institute) Kai Xu (Peking University Cancer Hospital & Institute) Peng Yuan (Peking University Cancer Hospital & Institute) Ming Cui (Peking University Cancer Hospital & Institute) Chenghai Zhang (Peking University Cancer Hospital & Institute) Hong Yang (Peking University Cancer Hospital & Institute) Zhendan Yao (Peking University Cancer Hospital & Institute) Nan Zhang (Peking University Cancer Hospital & Institute) Fei Tan (Peking University Cancer Hospital & Institute) Xiangqian Su (Peking University Cancer Hospital & Institute)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제20권 제3호

발행연도: 2020.1

수록면: 290 - 299 (10page)

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aPurpose: Recently, totally laparoscopic gastrectomy has been gradually accepted by surgeons worldwide for gastric cancer treatment. Complete dissection of the lymph nodes and the establishment of the surgical margin are the most important considerations for curative gastric cancer surgery. Previous studies have demonstrated that indocyanine green (ICG)-traced laparoscopic gastrectomy significantly improves the completeness of lymph node dissection. However, it remains difficult to identify the tumor location intraoperatively for gastric cancers that are staged ≤T3. Here, we investigated the feasibility of ICG fluorescence for lymph node mapping and tumor localization during totally laparoscopic distal gastrectomy. Materials and Methods: Preoperative and perioperative data from consecutive patients with gastric cancer who underwent a totally laparoscopic distal gastrectomy were collected and analyzed. The patients were categorized into the ICG (n=61) or the non-ICG (n=75) group based on whether preoperative endoscopic mucosal ICG injection was performed. Results: The ICG group had a shorter operation time and less intraoperative blood loss. Moreover, significantly more lymph nodes were harvested in the ICG group than the non-ICG group. No pathologically positive margin was found and there was no significant difference in either the proximal or distal surgical margins between the 2 groups. Conclusions: Near-infrared fluorescence imaging with ICG can be successfully used in totally laparoscopic distal gastrectomy, and it contributes to both the completeness of D2 lymph node dissection and confirmation of the gastric transection line. Well-designed prospective randomized studies are needed in the future to fully validate our findings.

#Gastric cancer #Gastrectomy #Indocyanine green #Tumor #Lymph node dissection

참고문헌 (29)

참고문헌 신청

Japanese Gastric Cancer Association / 2020 / Japanese gastric cancer treatment guidelines 2018 (5th edition) / Gastric Cancer

Hu Y / 2016 / Morbidity and mortality of laparoscopic versus open D2 distal gastrectomy for advanced gastric cancer : a randomized controlled trial / J Clin Oncol 34:1350~1357

Lee HJ / 2019 / Short-term outcomes of a multicenter randomized controlled trial comparing laparoscopic distal gastrectomy with D2 lymphadenectomy to open distal gastrectomy for locally advanced gastric cancer(KLASS-02-RCT) / Ann Surg 270:983~991

Wang Z / 2019 / Short-term surgical outcomes of laparoscopy-assisted versus open D2 distal gastrectomy for locally advanced gastric cancer in North China : a multicenter randomized controlled trial / Surg Endosc 33:33~45

Yu J / 2019 / Effect of laparoscopic vs open distal gastrectomy on 3-year disease-free survival in patients with locally advanced gastric cancer : the CLASS-01 randomized clinical trial / JAMA 321:1983~1992

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