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Assessment of Laparoscopic Indocyanine Green Tracer-guided Lymphadenectomy After Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer: A Randomized Controlled Trial.
Huang, Ze-Ning; Tang, Yi-Hui; Zhong, Qing; Li, Ping; Xie, Jian-Wei; Wang, Jia-Bin; Lin, Jian-Xian; Lu, Jun; Cao, Long-Long; Lin, Mi; Tu, Ru-Hong; Zheng, Chao-Hui; Chen, Qi-Yue; Huang, Chang-Ming.
Afiliación
  • Huang ZN; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
  • Tang YH; Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou, China.
  • Zhong Q; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
  • Li P; Department of Medical Microbiology, Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China.
  • Xie JW; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
  • Wang JB; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
  • Lin JX; Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou, China.
  • Lu J; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
  • Cao LL; Department of Medical Microbiology, Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China.
  • Lin M; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
  • Tu RH; Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou, China.
  • Zheng CH; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
  • Chen QY; Department of Medical Microbiology, Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China.
  • Huang CM; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Ann Surg ; 279(6): 923-931, 2024 Jun 01.
Article en En | MEDLINE | ID: mdl-38375670
ABSTRACT

OBJECTIVE:

To assess the effectiveness of indocyanine green (ICG)-guided lymph node (LN) dissection during laparoscopic radical gastrectomy after neoadjuvant chemotherapy (NAC) in patients with locally advanced gastric cancer (LAGC).

BACKGROUND:

Studies on ICG imaging use in patients with LAGC on NAC are rare.

METHODS:

Patients with gastric adenocarcinoma (clinical T2-4NanyM0) who received NAC were randomly assigned to receive ICG-guided laparoscopic radical gastrectomy or laparoscopic radical gastrectomy alone. Here, we reported the secondary endpoints including the quality of lymphadenectomy (total retrieved LNs and LN noncompliance) and surgical outcomes.

RESULTS:

Overall, 240 patients were randomized. Of whom, 236 patients were included in the primary analysis (118 in the ICG group and 118 in the non-ICG group). In the ICG group, the mean number of LNs retrieved was significantly higher than in the non-ICG group within the D2 dissection (48.2 vs 38.3, P < 0.001). The ICG fluorescence guidance significantly decreased the LN noncompliance rates (33.9% vs 55.1%, P = 0.001). In 165 patients without baseline measurable LNs, ICG significantly increased the number of retrieved LNs and decreased the LN noncompliance rate ( P < 0.05). For 71 patients with baseline measurable LNs, the quality of lymphadenectomy significantly improved in those who had a complete response ( P < 0.05) but not in those who did not ( P > 0.05). Surgical outcomes were comparable between the groups ( P > 0.05).

CONCLUSIONS:

ICG can effectively improve the quality of lymphadenectomy in patients with LAGC who underwent laparoscopic radical gastrectomy after NAC.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Adenocarcinoma / Laparoscopía / Terapia Neoadyuvante / Gastrectomía / Verde de Indocianina / Escisión del Ganglio Linfático Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Surg Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Adenocarcinoma / Laparoscopía / Terapia Neoadyuvante / Gastrectomía / Verde de Indocianina / Escisión del Ganglio Linfático Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Surg Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos