Indocyanine green near-infrared imaging-guided lymph node dissection during oesophageal cancer surgery: A single-centre experience

This study aimed to investigate the feasibility of using indocyanine green (ICG) near-infrared (NIR) imaging during lymphadenectomy for oesophageal cancer. Eighty-seven patients with primary oesophageal cancer were enrolled in this study. All the enrolled patients received an endoscopic injection of...

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Published inFrontiers in surgery Vol. 9; p. 982306
Main Authors Chen, Saihua, Tian, Xiaofeng, Ju, Guanjun, Shi, Minxin, Chen, Yibiao, Wang, Qing, Dai, Wencheng, Li, Tinghua, Pan, Jing, Fan, Yihui
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 09.01.2023
Subjects
esophageal cancer
indocyanine green
lymphadenectomy
metastatic nodes
near infrared
Surgery
near infrared
esophageal cancer
metastatic nodes
indocyanine green
lymphadenectomy
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Summary:This study aimed to investigate the feasibility of using indocyanine green (ICG) near-infrared (NIR) imaging during lymphadenectomy for oesophageal cancer. Eighty-seven patients with primary oesophageal cancer were enrolled in this study. All the enrolled patients received an endoscopic injection of ICG between 40 min and 23 h before surgery. Nodal dissection during surgery was performed under fluorescence imaging visualisation, with the NIR signal shown in purple. ICG or ICG nodes were recorded station by station and were microscopically evaluated. Endoscopic peritumoral ICG injection was successfully performed in all patients. Major post-surgery complications included wound infection, pleural effusion, dysphonia, pneumonia and anastomotic fistula. No patients experienced ICG-related adverse events. A total of 2,584 lymph nodes were removed, and the mean number of lymph nodes for each patient was 29.70 ± 9.24. Most of the removed nodes (97.83%) were ICG , and 3.32% of the ICG nodes were metastatic. No metastatic nodes were ICG or belonged to an ICG lymph node station. The time from ICG injection to surgery did not affect the number of harvested lymph nodes. The use of ICG-NIR imaging during oesophageal cancer surgery can enhance the visualisation of lymph nodes during surgery. It is a feasible, safe and helpful technique for lymphadenectomy.
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Reviewed by: Efstahios Kotidis, Aristotle University of Thessaloniki, Greece Ioannis Rouvelas, Karolinska University Hospital, Sweden
Edited by: Dimitrios Schizas, National and Kapodistrian University of Athens, Greece
These authors have contributed equally to this work
Specialty Section: This article was submitted to Surgical Oncology, a section of the journal Frontiers in Surgery
ISSN:2296-875X
2296-875X
DOI:10.3389/fsurg.2022.982306