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Surgery Today
Published in: Surgery Today 10/2020

01-10-2020 | Gastrectomy | Original Article

Near-infrared fluorescence-guided surgery using indocyanine green facilitates secure infrapyloric lymph node dissection during laparoscopic distal gastrectomy

Authors: Shin-Hoo Park, Felix Berlth, Jong-Ho Choi, Ji-Hyeon Park, Yun-Suhk Suh, Seong-Ho Kong, Do Joong Park, Hyuk-Joon Lee, Han-Kwang Yang

Published in: Surgery Today | Issue 10/2020

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Abstract

Purpose

We aimed to investigate the usefulness of near-infrared indocyanine green (ICG)-enhanced fluorescence guidance for infrapyloric LN dissection in laparoscopic distal gastrectomy.

Methods

This study enrolled patients with early gastric cancer scheduled for laparoscopic distal gastrectomy. After intraoperative submucosal injection of ICG (0.1 mg/mL), LN dissection was conducted under near-infrared ICG fluorescence guidance. The operation time, bleeding events during infrapyloric LN dissection were analyzed. Cases were retrospectively 1:3 propensity-score matched to patients who underwent laparoscopic distal gastrectomy without ICG injection.

Results

The mean time from midline omentectomy to exposure of the right gastroepiploic vein was significantly shorter in the ICG group (n = 20) than in the non-ICG group (n = 60) (13.05 ± 5.77 vs 18.68 ± 7.92 min; p = 0.001), and the incidence of bleeding during infrapyloric LN dissection was lower in the ICG group (20% vs 68.3%, p < 0.001). The two groups did not differ significantly regarding the number of LNs retrieved from the infrapyloric area (p = 0.434).

Conclusions

Near-infrared ICG fluorescence guidance facilitates safe and fast infrapyloric LN dissection in laparoscopic distal gastrectomy.
Appendix
Available only for authorised users
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Metadata
Title
Near-infrared fluorescence-guided surgery using indocyanine green facilitates secure infrapyloric lymph node dissection during laparoscopic distal gastrectomy
Authors
Shin-Hoo Park
Felix Berlth
Jong-Ho Choi
Ji-Hyeon Park
Yun-Suhk Suh
Seong-Ho Kong
Do Joong Park
Hyuk-Joon Lee
Han-Kwang Yang
Publication date
01-10-2020
Publisher
Springer Singapore
Published in
Surgery Today / Issue 10/2020
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-01993-w

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