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Near-infrared fluorescence-guided surgery using indocyanine green facilitates secure infrapyloric lymph node dissection during laparoscopic distal gastrectomy
摘要： Purpose We aimed to investigate the usefulness of near-infrared indocyanine green (ICG)-enhanced fluorescence guidance for infrapyloric LN dissection in laparoscopic distal gastrectomy. Methods This study enrolled patients with early gastric cancer scheduled for laparoscopic distal gastrectomy. After intra-operative submucosal injection of ICG (0.1 mg/mL), LN dissection was conducted under near-infrared ICG fluorescence guidance. The operation time, bleeding events during infrapyloric LN dissection were analyzed. Cases were retrospectively 1:3 propensity-score matched to patients who underwent laparoscopic distal gastrectomy without ICG injection. Results The mean time from midline omentectomy to exposure of the right gastroepiploic vein was significantly shorter in the ICG group (n = 20) than in the non-ICG group (n = 60) (13.05 ± 5.77 vs 18.68 ± 7.92 min; p = 0.001), and the incidence of bleeding during infrapyloric LN dissection was lower in the ICG group (20% vs 68.3%, p < 0.001). The two groups did not differ significantly regarding the number of LNs retrieved from the infrapyloric area (p = 0.434). Conclusions Near-infrared ICG fluorescence guidance facilitates safe and fast infrapyloric LN dissection in laparoscopic distal gastrectomy.
关键词： Indocyanine green,Laparoscopic surgery,Lymph node dissection,Near-infrared imaging,Gastric cancer
更新于2025-09-23 15:21:01
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NIR Infrared imaging after peritumoral injection of indocyanine green to guide lymph node dissection in head and neck squamous cell carcinoma: A pilot feasibility study
摘要： In head and neck squamous cell carcinoma (HNSCC), neck dissection is part of the surgical therapy. Beyond to the fact that radicality is a critical prognostic factor, this dissection could lead to significant morbidity, potentially avoidable when resected lymph nodes (LN) are proven to be non-invaded at pathology. Therefore, the definition of a method able to reliably identify the specific LN drainage area in HNSCC would represent a relevant progress, to better guide the neck dissection, potentially improving the radicality and reducing the morbidity. As near-infrared fluorescence imaging (NIR-FI) after indocyanine green (ICG) peritumoral injection has been validated as a sentinel procedure, we hypothesized that this approach could represent a new technique to identify the tumor-drainage area in HNSCC. We prospectively evaluated this technique in 14 patients with oral or oropharyngeal carcinoma scheduled for primary tumor resection and LN dissection. The trial was approved by the ethics committee of the Institut Jules Bordet (CE-2178) (EudraCT 2014-000298-37) and all patients signed informed consent before inclusion.
关键词： Head and neck squamous cell carcinoma,Indocyanine green,Near-infrared fluorescence imaging,Lymph node dissection,Surgical guidance
更新于2025-09-23 15:21:01