The safety and feasibility of laparoscopic indocyanine green fluorescence mapping during sentinel node navigational surgery for early gastric cancer
10.3760/cma.j.cn113855-20240813-00531
- VernacularTitle:早期胃癌吲哚菁绿荧光腹腔镜前哨淋巴结导航手术的可行性评价
- Author:
Chunguang GUO
1
;
Zefeng LI
;
Tongbo WANG
;
Xiaojie ZHANG
;
Chongyuan SUN
;
Hu REN
;
Yong LIU
;
Lizhou DOU
;
Shun HE
;
Yueming ZHANG
;
Guiqi WANG
;
Dongbing ZHAO
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院胰胃外科，北京 100021
- Keywords:
Stomach neoplasms;
Sentinel lymph node;
Indocyanine green;
Laparoscopy
- From:
Chinese Journal of General Surgery
2024;39(10):770-775
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and feasibility of the laparoscopic indocyanine green (ICG) fluorescence imaging during the sentinel node navigational surgery for the early gastric cancer.Methods:Patients with <4 cm early gastric cancer were chosen. 0.5 ml ICG (2.5 mg/ml) was preoperatively injected into submucosa around the lesion in four points by the endoscopy. The sentinel lymph node basin including the stained tissue and lymph node (LN) were completely resected guided by the fluorescence mapping under ICG laparoscopy. The specimen was inspected by frozen pathology section. The radical gastrectomy was dependent on the pathology result.Result:Between 2019 and 2021, a total of 18 patients were included in the final analysis. Most tumors (16/18) located in the middle or distal stomach. Median tumor size was 2.0 cm. Lymph vessel invasion was revealed in five cases and perineural invasion in three cases. According to AJCC tumor grading system, tumor depth was classified as Tis in 2 cases, T1a in 5 cases and T1b in 11 cases. Lymph node metastasis (LNM) was revealed in four patients (4/18, 22%). Median sentinel lymph node basins per patient were 2 (range, 1-5). An average 6 (range, 2-13) LNs were harvested in each case, including 6 (1-13) ICG stained LNs and 1 (0-5) non stained LNs. All of four LNM patients were detected by sentinel node navigational surgery. The rate of the sensitivity and accuracy were 100% and 100%, respectively. The median follow-up for the entire group was 58.3 months (0.3-59.9 months), with no recurrence or metastasis observed in any patient.Conclusion:The sensitivity and accuracy of the laparoscopic indocyanine green fluorescence imaging during the sentinel node navigational surgery were satisfactory.
