Near-Infrared Imaging Using Indocyanine Green for Laparoscopic Lateral Pelvic Lymph Node Dissection for Clinical Stage II/III Middle-Lower Rectal Cancer: A Propensity Score-Matched Cohort Study

Ohya, Hiroki; Watanabe, Jun; Suwa, Hirokazu; Suwa, Yusuke; Ozawa, Mahito; Ishibe, Atsushi; Kunisaki, Chikara; Endo, Itaru

doi:10.1097/dcr.0000000000002156

Cited by 16 publications

(19 citation statements)

References 35 publications

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“…It can decrease incorrect operations at the wrong level and reduce unnecessary damage to vessels and nerves during the process. This is the basic principle to avoid accidental bleeding and damage during LPND ( 2 , 30 ).…”

Section: Discussionmentioning

confidence: 99%

“…Lateral pelvic lymph node metastasis is an important metastasis pathway of middle and low rectal cancer ( 1 , 2 ). Sugihara et al ( 32 ) found that the overall survival rate of patients with LPNM was significantly lower than that of patients with negative LPNM.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, ICG fluorescence-guided laparoscopic LPND can provide effective guidance for detecting concealed LPLNs and reduce the risk of local recurrence within 1 year after the operation. We recommend further dissection of residual lymph nodes for patients with residual LPNM shown in CT or MRI, which can bring better short-term oncological outcomes for middle and low rectal cancer ( 2 , 30 , 31 ).…”

Section: Discussionmentioning

confidence: 99%

“…Lateral pelvic lymph node metastasis (LPNM) was related to local recurrence after radical resection due to a high incidence of LPNM in patients with middle and low rectal cancer ( 1 , 2 ). As a standard treatment, pre-operative chemoradiotherapy (CRT) plus total mesorectal excision (TME) has been recommended for patients with advanced rectal cancer with or without LPNM in western countries ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…Ogura et al ( 5 ) discovered that the application of LPLN dissection (LPND) results in a significantly lower lateral local recurrence rate in patients with low cT3/4 rectal cancer. The latest Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines recommends that LPND is an effective treatment strategy for patients with LPNM ( 2 , 6 , 7 ). Thus far, the safety and feasibility of LPND for rectal cancer with clinical evidence of LPNM has been widely confirmed by other Asian countries, such as China, and South Korea ( 8 – 11 ).…”

Section: Introductionmentioning

confidence: 99%

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Short-term outcomes of near-infrared imaging using indocyanine green in laparoscopic lateral pelvic lymph node dissection for middle-lower rectal cancer: A propensity score-matched cohort analysis

Dai

Han²,

Wang³

et al. 2022

Front. Med.

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Laparoscopic lateral pelvic lymph node dissection (LPND) is limited by complex neurovascular bundles in the narrow pelvic sidewall and various post-operative complications. Indocyanine green (ICG) has been applied to increase the number of harvested lymph nodes and reduce the injury of irrelevant vessels in patients with rectal cancer. However, few studies on the recurrence rate of ICG fluorescence imaging-guided laparoscopic LPND were reported. This retrospective study enrolled 50 middle- low rectal cancer patients who were treated by LPND. After propensity score matching, 20 patients were matched in each of the indocyanine green (ICG) guided imaging group (ICG group) and non-ICG guided imaging group (non-ICG group). The average follow-up time was 13.5 months (12–15 months). Our results showed that the total number of harvested lymph nodes in the ICG group was significantly higher than that in the non-ICG group (P < 0.05), and intraoperative blood loss and post-operative hospital stay times in the ICG group were less than those in the non-ICG group (P < 0.05). After 12 months of follow-up, no residual lymph node and local tumor recurrence were found for patients in the ICG group. Four patients in the non-ICG group detected residual lymph nodes at the 3-month visit. Our findings highlighted the importance of ICG fluorescence-guided imaging in LPND because it has unique advantages in improving the number of lymph node dissections, surgical accuracy, and decreasing the residual lymph nodes and local tumor recurrence. In addition, ICG fluorescence guidance technology can effectively shorten the operation time, and it is simple to operate, which is worth popularizing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Short-term outcomes of near-infrared imaging using indocyanine green in laparoscopic lateral pelvic lymph node dissection for middle-lower rectal cancer: A propensity score-matched cohort analysis

Dai

Han²,

Wang³

et al. 2022

Front. Med.

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Essential updates 2020/2021: Advancing precision medicine for comprehensive rectal cancer treatment

Takemasa

Hamabe

Miyo

et al. 2022

Annals of Gastroent Surgery

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In the paradigm shift related to rectal cancer treatment, we have to understand a variety of new emerging topics to provide appropriate treatment for individual patients as precision medicine. However, information on surgery, genomic medicine, and pharmacotherapy is highly specialized and subdivided, creating a barrier to achieving thorough knowledge. In this review, we summarize the perspective for rectal cancer treatment and management from the current standard‐of‐care to the latest findings to help optimize treatment strategy.

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Indocyanine green fluorescence imaging for lymph node detection and long‐term clinical outcomes in colorectal cancer surgery: A systematic review and meta‐analysis

Guo,

Luo,

et al. 2024

World j. surg.

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BackgroundThe indocyanine green fluorescence imaging (ICG‐FI) technique is increasingly being used in laparoscopic colorectal surgery for lymph node mapping. However, there is no definitive standard regarding whether the application of this technique can significantly increase the detection rate of metastatic lymph nodes and improve long‐term prognosis.MethodsPubMed, Embase, Web of Science, and Cochrane Library databases were searched to include studies including ICG‐FI in laparoscopic colorectal surgery. Data on the detection rate of lymph nodes, metastatic rate of ICG‐positive nodes, and long‐term clinical outcomes were extracted following inclusion criteria.ResultsEighteen studies with a total of 1552 patients 922 with ICG‐guided laparoscopic and 630 without ICG technique were finally included. Clinical stage II/III colorectal tumors were the most commonly studies types. The patients using the ICG‐FI technique had more harvested lymph nodes (weighted mean: 23.5 vs. 18.9; WMD = 4.6; p < 0.00001) during dissection but a lower metastasis rate of ICG‐positive nodes (61/218 [28%] vs. 96/333 [28.9%]; OR = 1.45; p = 0.08). Compared with conventional laparoscopic colorectal surgery, additional ICG‐FI technique did not improve the 3 year overall survival rate (272/289 [94.1%] vs. 269/289 [93.1%]; OR = 1.19; p = 0.61), relapse‐free survival (246/289 [85.1%] vs. 249/289 [86.2%]; OR = 0.92; p = 0.72), and local recurrence rate (22/289 [7.6%] vs. 28/289 [9.7%]; OR = 0.77; p = 0.38). The overall detection rate of sentinel lymph nodes, lymph flow, and metastatic rate of ICG‐positive nodes with the help of ICG‐FI were 86.8%, 89.9%, and 22.8%, respectively. No patients experienced major adverse events during ICG injection preoperatively or postoperatively.ConclusionsIndocyanine green fluorescence imaging‐guided procedure, compared to conventional laparoscopic dissection, can assist in obtaining a greater number of harvested lymph nodes and metastatic lymph nodes, however, it did not significantly improve the long‐term clinical outcomes.Level of evidenceLevel III systematic review of randomized control and nonrandomized studies.

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Near-Infrared Imaging Using Indocyanine Green for Laparoscopic Lateral Pelvic Lymph Node Dissection for Clinical Stage II/III Middle-Lower Rectal Cancer: A Propensity Score-Matched Cohort Study

Cited by 16 publications

References 35 publications

Short-term outcomes of near-infrared imaging using indocyanine green in laparoscopic lateral pelvic lymph node dissection for middle-lower rectal cancer: A propensity score-matched cohort analysis

Short-term outcomes of near-infrared imaging using indocyanine green in laparoscopic lateral pelvic lymph node dissection for middle-lower rectal cancer: A propensity score-matched cohort analysis

Essential updates 2020/2021: Advancing precision medicine for comprehensive rectal cancer treatment

Indocyanine green fluorescence imaging for lymph node detection and long‐term clinical outcomes in colorectal cancer surgery: A systematic review and meta‐analysis

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