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Published in: Annals of Surgical Oncology 6/2024

20-01-2024 | Esophageal Cancer | Thoracic Oncology

Comparison of Postoperative Outcomes Between Near-Infrared Fluorescent Imaging-Guided Mediastinal Lymphadenectomy and Conventional Surgery for Esophageal Cancer

Authors: Yong Ao, MD, LeQi Zhong, MD, KongJia Luo, MD, PhD, ShiNing Li, MD, Xin Zhang, MD, Lu Shao, MD, XiaoDan Lin, BS, Yi Hu, MD

Published in: Annals of Surgical Oncology | Issue 6/2024

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Abstract

Background

The study aimed to evaluate the efficacy of using near-infrared fluorescent imaging (NIRF) imaging with indocyanine green as an intraoperative tool for achieving complete mediastinal lymph node (LN) resection.

Patients and Methods

Between September 2019 and July 2021, patients with potential for esophagectomy due to middle and lower thoracic esophageal cancer were enrolled in this study. All patients were scheduled for NIRF-guided mediastinal lymphadenectomy during esophageal cancer surgery and were appropriately assigned to the NIRF group. Patients who underwent esophagectomy between September 2017 and September 2019 were assigned to the historical control group upon satisfying the inclusion/exclusion criteria. Surgical outcomes and the number of removed LNs were compared between the two groups using 1:1 propensity score matching.

Results

Of 67 eligible patients, 59 patients were included in the NIRF group after postsurgical exclusions. The operative time was significantly shorter in the NIRF group than in the historical control group [180 (140–420) min versus 202 (137–338) min; P < 0.001]. The incidence of postoperative chylothorax and hoarseness were significantly lower in the NIRF group than in the historical control group (0% versus 10.2 %; P = 0.036, 3.4% versus 13.6%; P = 0.047). The number of dissected total LNs, mediastinal LNs, and negative LNs was significantly larger in the NIRF group than in the historical control group. The number of overall metastatic LNs and abdominal LNs was comparable between the two groups.

Conclusions

NIRF imaging can assist in the thorough and complete mediastinal LNs dissections without increasing complications in patients undergoing esophagectomy.
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Metadata
Title
Comparison of Postoperative Outcomes Between Near-Infrared Fluorescent Imaging-Guided Mediastinal Lymphadenectomy and Conventional Surgery for Esophageal Cancer
Authors
Yong Ao, MD
LeQi Zhong, MD
KongJia Luo, MD, PhD
ShiNing Li, MD
Xin Zhang, MD
Lu Shao, MD
XiaoDan Lin, BS
Yi Hu, MD
Publication date
20-01-2024
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-024-14937-2

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