Near-Infrared Fluorescence Image-Guided Surgery in Esophageal and Gastric Cancer Operations

Ekman, Marcin; Girnyi, Sergii; Marano, Luigi; Roviello, Franco; Chand, Manish; Diana, Michele; Połom, Karol

doi:10.1177/15533506211073417

Cited by 10 publications

(5 citation statements)

References 102 publications

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“…In recent years, ICG fluorescence imaging for LNs tracing has attracted surgeons' attention and ICG imagingguided lymphadenectomy has been introduced in GC surgery (9)(10)(11). Until now, several studies have reported that ICG imagingguided lymphadenectomy was applied to GC surgery and showed promising results in increasing the number of retrieved LNs, without increasing operative time and overall complications (12)(13)(14). However, whether ICG imaging-guided lymphadenectomy is indeed beneficial for LNs dissection remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of indocyanine green fluorescence imaging-guided lymphadenectomy in radical gastrectomy for gastric cancer: A systematic review and meta-analysis

Dong

Zhang

et al. 2022

Front. Oncol.

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BackgroundIndocyanine green (ICG) imaging-guided lymphadenectomy has been introduced in gastric cancer (GC) surgery and its clinical value remains controversial. The aim of this study is to evaluate the efficacy of ICG fluorescence imaging-guided lymphadenectomy in radical gastrectomy for GC.MethodsStudies comparing lymphadenectomy in radical gastrectomy between use and non-use of ICG fluorescence imaging up to July 2022 were systematically searched from PubMed, Web of Science, Embase and Cochrane Library. A pooled analysis was performed for the available data regarding the baseline features, the number of retrieved lymph nodes (LNs), the number of metastatic LNs and surgical outcomes as well as oncological outcomes. RevMan 5.3 software was used to perform the statistical analysis. Quality evaluation and publication bias were also conducted.Results17 studies with a total of 2274 patients (1186 in the ICG group and 1088 in the control group) undergoing radical gastrectomy and lymphadenectomy were included. In the pooled analysis, the baseline features were basically comparable. However, the number of retrieved LNs in the ICG group was significantly more than that in the control group (MD = 7.41, 95% CI = 5.44 to 9.37, P < 0.00001). No significant difference was found between the ICG and control groups in terms of metastatic LNs (MD = -0.05, 95% CI = -0.25 to 0.16, P = 0.65). In addition, the use of ICG could reduce intraoperative blood loss (MD = -17.96, 95% CI = -27.89 to -8.04, P = 0.0004) without increasing operative time (P = 0.14) and overall complications (P = 0.10). In terms of oncological outcomes, the use of ICG could reduce the overall recurrence rate (OR = 0.50; 95% CI 0.28-0.89; P = 0.02) but could not increase the 2-year overall survival rate (OR = 1.25; 95% CI 0.72-2.18; P = 0.43).ConclusionsICG imaging-guided lymphadenectomy is valuable for complete LNs dissection in radical gastrectomy for GC. However, more high-quality randomized controlled trials are needed to confirm this benefit.

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Section: Introductionmentioning

confidence: 99%

Efficacy of indocyanine green fluorescence imaging-guided lymphadenectomy in radical gastrectomy for gastric cancer: A systematic review and meta-analysis

Dong

Zhang

et al. 2022

Front. Oncol.

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“…Multiple clinical studies have been conducted on intraoperative uorescence imaging for esophageal cancer. The results have demonstrated the advantages of this technology in the accurate identi cation and dissection of esophageal cancer lymph nodes [31][32][33][34].…”

Section: Discussionmentioning

confidence: 80%

Perioperative outcomes and survival of indocyanine green guided minimally esophagectomy in patients with esophageal cancer: a retrospective comparison study

Shen,

Chen,

et al. 2024

Preprint

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Background With the expansion of clinical investigations on intraoperative fluorescence imaging in esophageal cancer, the advantages of this technique in precise lymph node identification and dissection have been demonstrated. However, certain issues remain unaddressed. This study aimed to evaluate the safety and feasibility of indocyanine green (ICG)-guided lymph node dissection in radical esophagectomy for patients with esophageal squamous cell carcinoma and assess its long-term outcomes, thereby providing a theoretical basis for further research. Results A total of 176 patients were included in the statistical analysis. The two groups were comparable in terms of basic characteristics. The mean number of Dissected lymph nodes by pathologist in the ICG Group was significantly higher than that in the Non-ICG Group (27.7 ± 2.1 vs. 20.5 ± 1.4, P < 0.001), The number of positive lymph node station(metastasis mediastinal lymph nodes) in ICG group was higher than that in non-ICG Group. There was no significant difference in results of postoperative complications between the two groups (P > 0.05).The non-ICG group exhibited higher event rates and poorer survival outcomes in both DFS and OS compared to the ICG group, with statistically significant differences observed(P < 0.005). Conclusions ICG-guided lymph node dissection during minimally invasive esophageal cancer surgery can significantly improve patient survival outcomes without increasing the rate of relevant postoperative complications.

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“…Moreover, multispectral visualization of different lymphatic regions of interest using combinations of fluorophores has also been studied 59 . Fluorescent visualization of sentinel nodes has not only been described for breast cancer and melanoma, but also other malignancies, including gynaecological, gastrointestinal, endocrine, head and neck, and urological malignancies 60–65 .…”

Section: Lymph Node Targetingmentioning

confidence: 99%

Fluorescence-guided surgery: comprehensive review

Sutton

Dam

et al. 2023

BJS Open

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Background Despite significant improvements in preoperative workup and surgical planning, surgeons often rely on their eyes and hands during surgery. Although this can be sufficient in some patients, intraoperative guidance is highly desirable. Near-infrared fluorescence has been advocated as a potential technique to guide surgeons during surgery. Methods A literature search was conducted to identify relevant articles for fluorescence-guided surgery. The literature search was performed using Medical Subject Headings on PubMed for articles in English until November 2022 and a narrative review undertaken. Results The use of invisible light, enabling real-time imaging, superior penetration depth, and the possibility to use targeted imaging agents, makes this optical imaging technique increasingly popular. Four main indications are described in this review: tissue perfusion, lymph node assessment, anatomy of vital structures, and tumour tissue imaging. Furthermore, this review provides an overview of future opportunities in the field of fluorescence-guided surgery. Conclusion Fluorescence-guided surgery has proven to be a widely innovative technique applicable in many fields of surgery. The potential indications for its use are diverse and can be combined. The big challenge for the future will be in bringing experimental fluorophores and conjugates through trials and into clinical practice, as well as validation of computer visualization with large data sets. This will require collaborative surgical groups focusing on utility, efficacy, and outcomes for these techniques.

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Near-Infrared Fluorescence Image-Guided Surgery in Esophageal and Gastric Cancer Operations

Cited by 10 publications

References 102 publications

Efficacy of indocyanine green fluorescence imaging-guided lymphadenectomy in radical gastrectomy for gastric cancer: A systematic review and meta-analysis

Efficacy of indocyanine green fluorescence imaging-guided lymphadenectomy in radical gastrectomy for gastric cancer: A systematic review and meta-analysis

Perioperative outcomes and survival of indocyanine green guided minimally esophagectomy in patients with esophageal cancer: a retrospective comparison study

Fluorescence-guided surgery: comprehensive review

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