Fluorescence-guided colorectal surgery: applications, clinical results, and protocols

Jung, Jin-Min; Park, In Ja; Park, Eun Jung; Son, Gyung Mo; ,

doi:10.4174/astr.2023.105.5.252

Cited by 4 publications

(2 citation statements)

References 79 publications

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“…The use of ICG during LLND is an auspicious technique since it provides great accuracy and efficacy for identifying lymphatic tissue inside the deep and narrow pelvis, leading to an increased number of lymph nodes harvested and probably improved oncological outcomes [ 13 ]. Various applications of ICG use are described in literature, from sentinel node identification to the recognition and matching of suspicious lymph nodes after 3D reconstruction images [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Blood loss, increased operative time, and urogenital dysfunction owing to inadvertent autonomic nerve injury are the main aspects requiring standardized and minimally invasive approaches. Indocyanine green (ICG) near-infrared (NIR) fluorescence is an innovative technology enabling the detection of the lymphatic drainage of rectal cancer when injected submucosally, offering the advantage of improved lymph node harvesting with greater accuracy and enhanced postoperative outcomes [ 13 ]. Furthermore, the application of ICG NIR fluorescence enables lymph node harvesting not only by directly performing a lateral pelvic dissection, but also by detecting the lateral pelvic sentinel lymph node (LPSLN) and deciding further treatment depending on its metastatic status [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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The use of indocyanine green for lateral lymph node dissection in rectal cancer—preliminary data from an emerging procedure: a systematic review of the literature

Kehagias,

Lampropoulos,

Bellou

et al. 2024

Tech Coloproctol

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Introduction Lateral lymph node dissection (LLND) for rectal cancer is still not a widely established technique owing to the existing controversy between Eastern and Western countries and the lack of well-designed studies. The risk of complications and the paucity of long-term oncological results are significant drawbacks for further applying this technique. The use of indocyanine green (ICG) near-infrared (NIR) fluorescence for LLND appears as a promising technique for enhancing postoperative and oncological outcomes. This review aims to evaluate the emerging role of ICG during LLND and present the benefits of its application. Materials and methods Systematic electronic research was conducted in PubMed and Google Scholar using a combination of medical subject headings (MeSH). Studies presenting the use of ICG during LLND, especially in terms of harvested lymph nodes, were included and reviewed. Studies comparing LLND with ICG (LLND + ICG) or without ICG (LLND-alone) were further analyzed for the number of lymph nodes and postoperative outcomes. Results In total, 13 studies were found eligible and analyzed for different parameters. LLND + ICG is associated with significantly increased number of harvested lateral lymph nodes (p < 0.05), minor blood loss, decreased operative time, and probably decreased urinary retention postoperatively compared with LLND-alone. Conclusions The use of ICG fluorescence during LLND is a safe and feasible technique for balancing postoperative outcomes and the number of harvested lymph nodes. Well-designed studies with long-term results are required to elucidate the oncological benefits and establish this promising technique.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The use of indocyanine green for lateral lymph node dissection in rectal cancer—preliminary data from an emerging procedure: a systematic review of the literature

Kehagias,

Lampropoulos,

Bellou

et al. 2024

Tech Coloproctol

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Role of fluorescence navigation with indocyanine green during lateral pelvic lymphodissection in the treatment of rectal cancer (meta-analysis)

Tishkevich,

Alekseev,

Khomyakov

et al. 2024

Koloproktologiâ

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INTRODUCTION: intraoperative fluorescence navigation with indocyanine green (ICG) allows visualizing possible affected lymph nodes, which hypothetically provides more precise lateral pelvic node dissection (LPND).AIM: to compare immediate results of lateral pelvic node dissection (LPND) combined with fluorescence navigation with ICG and conventional LPND for the treatment of metastatic lesions of lateral pelvic lymph nodes in patients with rectal cancer.PATIENTS AND METHODS: search was performed in the PubMed library (National Library of Medicine, Bethesda, MD, USA) with keywords “indocyanine green,” “ICG“, ”lymph nodes,” “lateral lymph node dissection,” and “rectal cancer” in various combinations. Four non-randomized studies were included in meta-analysis, three retrospective and one prospective, on the outcomes of ICG use during LPND in patients with rectal cancer in the meta-analysis.RESULTS: significantly more lymph nodes were harvested in LPND + ICG group (MD = 4.5; 95% CI: 3.0–5.9; p < 0.00001). The operation time was longer in the ICG group (MD = 32.5; 95% CI: 2.8–62.3; p = 0.03). Intraoperative blood loss was higher in conventional LPND group (MD = −52.6; 95% CI: −89.8 — −15.3; p = 0.006). Hospital stay was significantly shorter in ICG group (MD = −1.2; 95% CI: −2.0 — −0.4; p = 0.003). Patients who underwent standard LPND were significantly more likely to have postoperative urinary retention (OR = 0.4; 95% CI: 0.1–0.9; p = 0.03).CONCLUSION: fluorescence navigation with ICG improves early results of LPND. Further accumulation of experience with dynamic follow-up of patients is crucial.

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Accurate Co-Localization of Luciferase Expression and Fluorescent Anti-CEA Antibody Targeting of Liver Metastases in an Orthotopic Mouse Model of Colon Cancer

Lee,

Cox,

Amirfakhri

et al. 2024

Cancers

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Background: The present study aimed to validate the accuracy of a tumor-specific antibody to target liver metastases of colorectal cancer. Methods: A humanized anti-CEA antibody conjugated to a fluorescent dye (M5A-IR800) was tested for targeting human colorectal cancer liver metastases (CRLMs) expressing luciferase in an orthotopic mouse model. Orthotopic mouse models of CRLMs were established by implanting fragments of a luciferase-expressing human colorectal cancer cell line, LS174T, in the liver of nude mice. Mice received 50 µg M5A-IR800 72 h prior to imaging. To test co-localization, bioluminescence imaging was performed using D-luciferin, which was given via intraperitoneal injection just prior to imaging. Results: Tumors were able to be visualized non-invasively through the skin with the luciferase–luciferin signal. Intra-abdominal imaging showed accurate labeling of CRLMs with M5A-IR800, which co-localized with the luciferase–luciferin signal. Conclusions: The present results validate the accuracy of a tumor-specific anti-CEA antibody in targeting liver metastases of colorectal cancer.

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Fluorescence-guided colorectal surgery: applications, clinical results, and protocols

Cited by 4 publications

References 79 publications

The use of indocyanine green for lateral lymph node dissection in rectal cancer—preliminary data from an emerging procedure: a systematic review of the literature

The use of indocyanine green for lateral lymph node dissection in rectal cancer—preliminary data from an emerging procedure: a systematic review of the literature

Role of fluorescence navigation with indocyanine green during lateral pelvic lymphodissection in the treatment of rectal cancer (meta-analysis)

Accurate Co-Localization of Luciferase Expression and Fluorescent Anti-CEA Antibody Targeting of Liver Metastases in an Orthotopic Mouse Model of Colon Cancer

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