Long-term outcomes of indocyanine green fluorescence imaging-guided laparoscopic lateral pelvic lymph node dissection for clinical stage II/III middle-lower rectal cancer: a propensity score-matched cohort study

Watanabe, Jun; Ohya, Hiroki; Sakai, Jun; Suwa, Yusuke; Goto, Kazumi; Nakagawa, Kazuhiko; Ozawa, Mahito; Ishibe, Atsushi; Suwa, Hirokazu; Kunisaki, Chikara; Endo, Itaru

doi:10.1007/s10151-023-02761-x

Cited by 19 publications

(15 citation statements)

References 34 publications

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“…2 . From the above studies, four compared LLND + ICG versus LLND-alone and adhered to the population, intervention, comparator, and outcome (PICO) framework for further analysis of postoperative parameters [ 19 , 25 , 27 , 28 ] (Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…[ 26 ] 2023 Retrospective 23 3.2 (1.2–6.5) a 4.3 (1–8) a T1 (2) T2 (6) T3 (15) NCRT (18) NCT (3) None (2) Watanabe et al. [ 27 ] 2023 Retrospective multicentered comparative 58 3.8 (2.5–5) c 5 (4–6.8) c T1 (4) T2(10) T3(38) T4(3) No (23/58, 39.7%) NCT (35/58, 60.3%) Tang et al. [ 28 ] 2023 Prospective non-randomized comparative 29 4 ( n = 21) > 4 ( n = 8) 4 (3–5) c T1 (4) T3 (25) NCRT (13) None (16) n sample size, NCRT neoadjuvant chemo-radiotherapy, NCT neoadjuvant chemotherapy, NR not reported a Values expressed as mean (range) b Values expressed as mean ± standard deviation (SD) c Values expressed as mean (interquartile range, IQR) …”

Section: Resultsmentioning

confidence: 99%

“…[ 26 ] Eisai Co. Ltd, Tokyo, Japan Optocam 2100 Optomedic, Guangdong, China 2.5 1.5 AA SM 3 points Transanal anoscope Watanabe et al. [ 27 ] DiagnoGreen Daiichi Pharmaceuticals, Tokyo, Japan KARL STORZ GmbH & Co. KG, Germany; Stryker Corporation (1588 AIM Platform; Michigan, USA) 2.5 1 AA SM 4 points Transanal direct vision or endoscope Tang et al. [ 28 ] NR DPM-III-01 (Zhuhai Dipu Medical Technology Co., Ltd.) 1.25 0.8 1 h BA SM 3–4 points Transanal anoscope or colonoscope BA before anesthesia, AA after anesthesia, SM submucosa, NR not reported …”

Section: Resultsmentioning

confidence: 99%

“…[ 26 ] 2023 23 21/23 (76.2%) 10.2 (3–18) a Most common obturator Watanabe et al. [ 27 ] 2023 58 – 14 (10–18) c NR Tang et al. [ 28 ] 2023 29 12 (8–19) c Most internal iliac Number of harvested lymph nodes and location of metastatic nodes n sample size, NR not reported, LPLN lateral pelvic lymph nodes a Values expressed as mean (range) b Values expressed as mean ± standard deviation (SD) c Values expressed as mean (interquartile range, IQR) …”

Section: Resultsmentioning

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: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

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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“…The injection of cyanoacrylate with ICG facilitated stabilization of the ICG dye, allowing it to be held only in the lymph node area. There is no evidence proving that this procedure spreads tumour cells, so this strategy offers an approach to find and reach the lymph node and to resect it, with a focus on complete local control, avoidance of extended resection with potential vascular and nerve injury and fewer complications [1][2][3][4].…”

Section: Dear Editormentioning

confidence: 99%

Redo robotic pelvic lateral lymph node dissection after percutaneous CT‐guided indocyanine green injection following total neoadjuvant therapy and laparoscopic approach for rectal adenocarcinoma: a video vignette

et al. 2023

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Recurrence of rectal cancer on the pelvic sidewall after lateral lymph node dissection

Takao,

Kawai,

Nakano

et al. 2024

Int J Colorectal Dis

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Purpose Although lateral lymph node dissection has been performed to prevent lateral pelvic recurrence in locally advanced lower rectal cancer, the incidence of lateral pelvic recurrence after this procedure has not been investigated. Therefore, this study aimed to investigate the long-term outcomes of patients who underwent lateral pelvic lymph node dissection, with a particular focus on recurrence patterns. Methods This was a retrospective study conducted at a single high-volume cancer center in Japan. A total of 493 consecutive patients with stage II-III rectal cancer who underwent lateral lymph node dissection between January 2005 and August 2022 were included. The primary outcome measures included patterns of recurrence, overall survival, and relapse-free survival. Patterns of recurrence were categorized as lateral or central pelvic. Results Among patients who underwent lateral lymph node dissection, 18.1% had pathologically positive lateral lymph node metastasis. Lateral pelvic recurrence occurred in 5.5% of patients after surgery. Multivariate analysis identified age > 75 years, lateral lymph node metastasis, and adjuvant chemotherapy as independent risk factors for lateral pelvic recurrence. Evaluation of the recurrence rate by dissection area revealed approximately 1% of recurrences in each area after dissection. Conclusion We demonstrated the prognostic outcome and limitations of lateral lymph node dissection for patients with advanced lower rectal cancer, focusing on the incidence of recurrence in the lateral area after the dissection. Our study emphasizes the clinical importance of lateral lymph node dissection, which is an essential technique that surgeons should acquire.

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Long-term outcomes of indocyanine green fluorescence imaging-guided laparoscopic lateral pelvic lymph node dissection for clinical stage II/III middle-lower rectal cancer: a propensity score-matched cohort study

Cited by 19 publications

References 34 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

Redo robotic pelvic lateral lymph node dissection after percutaneous CT‐guided indocyanine green injection following total neoadjuvant therapy and laparoscopic approach for rectal adenocarcinoma: a video vignette

Recurrence of rectal cancer on the pelvic sidewall after lateral lymph node dissection

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