Assessment of the Completeness of Lymph Node Dissection Using Near-infrared Imaging with Indocyanine Green in Laparoscopic Gastrectomy for Gastric Cancer
Journal of Gastric Cancer
; : 161-171, 2018.
Article
in En
| WPRIM
| ID: wpr-715194
Responsible library:
WPRO
ABSTRACT
PURPOSE:
This study assessed the feasibility of near-infrared (NIR) imaging with indocyanine green (ICG) in investigating the completeness of laparoscopic lymph node (LN) dissection for gastric cancer. MATERIALS ANDMETHODS:
Patients scheduled for laparoscopic gastrectomy for treating gastric cancer were enrolled in the study. After intraoperative submucosal ICG injection (0.05 mg/mL), LN dissection was performed under conventional laparoscopic light. After dissection, the LN stations of interest were examined under the NIR mode to locate any extra ICG-stained (E) tissues, which were excised and sent for pathologic confirmation. This technique was tested in 2steps:
infra-pyloric LN dissection (step 1) and review of all stations after proper radical node dissection (step 2).RESULTS:
In step 1, 15 patients who underwent laparoscopic pylorus-preserving gastrectomy (LPPG) and 15 patients who underwent laparoscopic distal gastrectomy (LDG) were examined. Seven and 2 E-tissues were obtained during LPPG and LDG, respectively. From the retrieved E-tissues, 1 and 0 tissue obtained during LPPG and LDG, respectively, was confirmed as LN. In step 2, 20 patients were enrolled (13 D1+ dissection and 7 D2 dissection). Six E-tissues were retrieved from 5 patients, and 1 tissue was confirmed as LN in the pathologic review. Overall, 15 E-tissues were detected and removed, and 2 tissues were confirmed as LNs in the pathologic review. Both nodes were from LN station #6, with 1 case each in the LDG and LPPG groups.CONCLUSIONS:
NIR imaging may provide additional node detection during laparoscopic LN dissection for gastric cancer, especially in the infra-pyloric area.Key words
Full text:
1
Index:
WPRIM
Main subject:
Stomach Neoplasms
/
Diagnostic Imaging
/
Gastrectomy
/
Indocyanine Green
/
Lymph Node Excision
/
Lymph Nodes
Type of study:
Diagnostic_studies
Limits:
Humans
Language:
En
Journal:
Journal of Gastric Cancer
Year:
2018
Type:
Article