Ignacio Maruri1,2, María Hermelinda Pardellas1,2, Oscar Cano-Valderrama3,4, Patricia Jove1,2, Marta López-Otero1,2, Isabel Otero1,2, Victor Campo5, Rebeca Fernández6, Nereida Fernández-Fernández7, Raquel Sánchez-Santos1,2. 1. Department of Surgery, Complejo Hospitalario Universitario de Vigo, C/Clara Campoamor 341, Vigo, Pontevedra, Spain. 2. Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain. 3. Department of Surgery, Complejo Hospitalario Universitario de Vigo, C/Clara Campoamor 341, Vigo, Pontevedra, Spain. oscarcanovalderrama@hotmail.com. 4. Instituto de Investigaciones Sanitarias Galicia Sur, Vigo, Spain. oscarcanovalderrama@hotmail.com. 5. Department of Public Health, Complejo Hospitalario Universitario de Vigo, Vigo, Spain. 6. Department of Pathology, Complejo Hospitalario Universitario de Vigo, Vigo, Spain. 7. Department of Gastroenterology, Complejo Hospitalario Universitario de Vigo, Vigo, Spain.
Abstract
BACKGROUND: Indocyanine green (ICG) guided lymphadenectomy has been proposed has a technique to improve the lymphadenectomy of patients with gastric cancer. Nevertheless, experience with this procedure is scarce in Western countries. METHODS: A retrospective analytic study in a tertiary hospital in Spain was performed, comparing patients who underwent laparoscopic gastrectomy with (ICG cohort) and without (historic cohort) ICG guided lymphadenectomy. RESULTS: Thirty four patients were included (17 in each group). Although the number of positive nodes was similar in both groups (0.0 in the ICG cohort vs. 2 in the historic cohort, p = 0.119), the number of lymph nodes removed was higher in the ICG cohort (42.0 vs 28.0, p = 0.040). In the ICG cohort, more lymph nodes were positive for adenocarcinoma in the group of nodes that were positive for IGC (10.6% of the IGC + nodes vs. 1.9% in the ICG - nodes, p < 0.001). CONCLUSIONS: ICG lymphadenectomy is a promising procedure that could improve the lymphadenectomy of patients with gastric cancer. ICG lymphadenectomy could be used to increase the number of lymph nodes removed in patients with a high-risk of nodal invasion or it could be used to reduce the surgical aggressiveness in fragile patients with a low-risk of nodal invasion.
BACKGROUND: Indocyanine green (ICG) guided lymphadenectomy has been proposed has a technique to improve the lymphadenectomy of patients with gastric cancer. Nevertheless, experience with this procedure is scarce in Western countries. METHODS: A retrospective analytic study in a tertiary hospital in Spain was performed, comparing patients who underwent laparoscopic gastrectomy with (ICG cohort) and without (historic cohort) ICG guided lymphadenectomy. RESULTS: Thirty four patients were included (17 in each group). Although the number of positive nodes was similar in both groups (0.0 in the ICG cohort vs. 2 in the historic cohort, p = 0.119), the number of lymph nodes removed was higher in the ICG cohort (42.0 vs 28.0, p = 0.040). In the ICG cohort, more lymph nodes were positive for adenocarcinoma in the group of nodes that were positive for IGC (10.6% of the IGC + nodes vs. 1.9% in the ICG - nodes, p < 0.001). CONCLUSIONS: ICG lymphadenectomy is a promising procedure that could improve the lymphadenectomy of patients with gastric cancer. ICG lymphadenectomy could be used to increase the number of lymph nodes removed in patients with a high-risk of nodal invasion or it could be used to reduce the surgical aggressiveness in fragile patients with a low-risk of nodal invasion.