Tetsuta Satoyoshi1, Kenji Okita2, Masayuki Ishii2, Atsushi Hamabe2, Akihiro Usui2, Emi Akizuki2, Koichi Okuya2, Toshihiko Nishidate2, Hiroo Yamano3, Hiroshi Nakase3, Ichiro Takemasa2. 1. Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, S1, W16, Chuo-ku, Sapporo, 060-8543, Japan. satoyoshi@sapmed.ac.jp. 2. Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, S1, W16, Chuo-ku, Sapporo, 060-8543, Japan. 3. Department of Gastroenterology and Hepatology, School of Medicine, Sapporo Medical University, S1, W16, Chuo-ku, Sapporo, 060-8543, Japan.
Abstract
BACKGROUND: Accurate identification of tumor sites during laparoscopic colorectal surgery helps to optimize oncological clearance. We aimed to assess the timing of the local injection preoperatively and clarify the usefulness and limitation of tumor site marking using indocyanine green (ICG) fluorescence imaging. METHODS: Consecutive patients who underwent primary colorectal cancer surgery from September 2017 to January 2019 were included. Preoperatively, lower endoscopy was used to inject the ICG solution into the submucosal layer near the tumor. During laparoscopic surgery, ICG fluorescence marking as the tumor site marking was detected using a laparoscopic near-infrared camera system. The detection rate and factors associated with successful intraoperative ICG fluorescence visualization including the interval between local injection and surgery were evaluated. RESULTS: One hundred sixty-five patients were enrolled. Using the laparoscopic near-infrared system, the intraoperative detection rates of ICG marking were 100% for ICG injection within 6 days preoperatively, 60% for injection between 7 and 9 days preoperatively, and 0% for injection earlier than 10 days preoperatively. There were no complications associated with ICG marking. Additionally, this method did not disturb the progress of the surgical procedure because injected ICG in the submucosal layer did not cause any tissue inflammation, and if ICG spilled into the serosa, it was invisible by white light. CONCLUSION: Advantages of ICG fluorescence tumor site marking were high visibility of infrared imaging during laparoscopic colorectal surgery and minimal adverse events of surgery. One of the most important findings regarding practical use was a rapid decrease in fluorescence marking visibility if one week passed from the time of ICG local injection.
BACKGROUND: Accurate identification of tumor sites during laparoscopic colorectal surgery helps to optimize oncological clearance. We aimed to assess the timing of the local injection preoperatively and clarify the usefulness and limitation of tumor site marking using indocyanine green (ICG) fluorescence imaging. METHODS: Consecutive patients who underwent primary colorectal cancer surgery from September 2017 to January 2019 were included. Preoperatively, lower endoscopy was used to inject the ICG solution into the submucosal layer near the tumor. During laparoscopic surgery, ICG fluorescence marking as the tumor site marking was detected using a laparoscopic near-infrared camera system. The detection rate and factors associated with successful intraoperative ICG fluorescence visualization including the interval between local injection and surgery were evaluated. RESULTS: One hundred sixty-five patients were enrolled. Using the laparoscopic near-infrared system, the intraoperative detection rates of ICG marking were 100% for ICG injection within 6 days preoperatively, 60% for injection between 7 and 9 days preoperatively, and 0% for injection earlier than 10 days preoperatively. There were no complications associated with ICG marking. Additionally, this method did not disturb the progress of the surgical procedure because injected ICG in the submucosal layer did not cause any tissue inflammation, and if ICG spilled into the serosa, it was invisible by white light. CONCLUSION: Advantages of ICG fluorescence tumor site marking were high visibility of infrared imaging during laparoscopic colorectal surgery and minimal adverse events of surgery. One of the most important findings regarding practical use was a rapid decrease in fluorescence marking visibility if one week passed from the time of ICG local injection.
Entities:
Keywords:
Colonic marking; Colorectal cancer; Indocyanine green fluorescence imaging; Laparoscopic surgery; Near infrared; Tumor location
Authors: J Sven D Mieog; Susan L Troyan; Merlijn Hutteman; Kevin J Donohoe; Joost R van der Vorst; Alan Stockdale; Gerrit-Jan Liefers; Hak Soo Choi; Summer L Gibbs-Strauss; Hein Putter; Sylvain Gioux; Peter J K Kuppen; Yoshitomo Ashitate; Clemens W G M Löwik; Vincent T H B M Smit; Rafiou Oketokoun; Long H Ngo; Cornelis J H van de Velde; John V Frangioni; Alexander L Vahrmeijer Journal: Ann Surg Oncol Date: 2011-03-01 Impact factor: 5.344
Authors: Ui Do Yeo; Nak Song Sung; Seung Jae Roh; Won Jun Choi; Kyung Ho Song; In Seok Choi; Dae Sung Yoon; Sang Eok Lee; Ju Ik Moon; Seong Uk Kwon; In Eui Bae; Seung Jae Lee Journal: J Minim Invasive Surg Date: 2020-09-15