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Securing Resection Margin Using Indocyanine Green Diffusion Range on Gastric Wall during NIR Fluorescence-Guided Surgery in Early Gastric Cancer Patients

SIMPLE SUMMARY: A retrospective analysis of 503 patients with early gastric cancer located in the body of the stomach who underwent fluorescence lymphography-guided gastrectomy revealed that the indocyanine green (ICG) diffusion area along the gastric wall secured a resection margin of >28 mm. Th...

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Autores principales: Cho, Minah, Kim, Ki-Yoon, Park, Sung Hyun, Kim, Yoo Min, Kim, Hyoung-Il, Hyung, Woo Jin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9658562/
https://www.ncbi.nlm.nih.gov/pubmed/36358639
http://dx.doi.org/10.3390/cancers14215223
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author Cho, Minah
Kim, Ki-Yoon
Park, Sung Hyun
Kim, Yoo Min
Kim, Hyoung-Il
Hyung, Woo Jin
author_facet Cho, Minah
Kim, Ki-Yoon
Park, Sung Hyun
Kim, Yoo Min
Kim, Hyoung-Il
Hyung, Woo Jin
author_sort Cho, Minah
collection PubMed
description SIMPLE SUMMARY: A retrospective analysis of 503 patients with early gastric cancer located in the body of the stomach who underwent fluorescence lymphography-guided gastrectomy revealed that the indocyanine green (ICG) diffusion area along the gastric wall secured a resection margin of >28 mm. The ICG diffusion range can be used as a simple and easy method for determining the resection margin during gastrectomy using near-infrared (NIR) imaging. ABSTRACT: Near-infrared (NIR) fluorescence lymphography-guided minimally invasive gastrectomy using indocyanine green (ICG) is employed to visualize draining lymphatic vessels and lymph nodes. Endoscopically injected ICG spreads along the gastric wall and emits fluorescence from the serosal surface of the stomach. We aimed to assess the efficacy of ICG diffusion in securing the resection margin. We retrospectively analyzed 503 patients with early gastric cancer located in the body of the stomach who underwent fluorescence lymphography-guided gastrectomy from 2018 to 2021. One day before surgery, ICG was endoscopically injected into four points of the submucosal layer peritumorally. We measured the extent of resection and the resection line based on the ICG diffusion area from the specimen using NIR imaging. The mean area of the ICG diffusion was 82.7 × 75.3 and 86.7 × 80.2 mm(2) on the mucosal and serosal sides, respectively. After subtotal gastrectomy, the length of the proximal resection margin was 38.1 ± 20.1, 33.4 ± 22.2, and 28.7 ± 17.2 mm in gastroduodenostomy, loop gastrojejunostomy, and Roux-en-Y gastrojejunostomy, respectively. The ICG diffusion area along the gastric wall secured a resection margin of >28 mm. The ICG diffusion range can be used as a simple and easy method for determining the resection margin during gastrectomy using NIR imaging.
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spelling pubmed-96585622022-11-15 Securing Resection Margin Using Indocyanine Green Diffusion Range on Gastric Wall during NIR Fluorescence-Guided Surgery in Early Gastric Cancer Patients Cho, Minah Kim, Ki-Yoon Park, Sung Hyun Kim, Yoo Min Kim, Hyoung-Il Hyung, Woo Jin Cancers (Basel) Article SIMPLE SUMMARY: A retrospective analysis of 503 patients with early gastric cancer located in the body of the stomach who underwent fluorescence lymphography-guided gastrectomy revealed that the indocyanine green (ICG) diffusion area along the gastric wall secured a resection margin of >28 mm. The ICG diffusion range can be used as a simple and easy method for determining the resection margin during gastrectomy using near-infrared (NIR) imaging. ABSTRACT: Near-infrared (NIR) fluorescence lymphography-guided minimally invasive gastrectomy using indocyanine green (ICG) is employed to visualize draining lymphatic vessels and lymph nodes. Endoscopically injected ICG spreads along the gastric wall and emits fluorescence from the serosal surface of the stomach. We aimed to assess the efficacy of ICG diffusion in securing the resection margin. We retrospectively analyzed 503 patients with early gastric cancer located in the body of the stomach who underwent fluorescence lymphography-guided gastrectomy from 2018 to 2021. One day before surgery, ICG was endoscopically injected into four points of the submucosal layer peritumorally. We measured the extent of resection and the resection line based on the ICG diffusion area from the specimen using NIR imaging. The mean area of the ICG diffusion was 82.7 × 75.3 and 86.7 × 80.2 mm(2) on the mucosal and serosal sides, respectively. After subtotal gastrectomy, the length of the proximal resection margin was 38.1 ± 20.1, 33.4 ± 22.2, and 28.7 ± 17.2 mm in gastroduodenostomy, loop gastrojejunostomy, and Roux-en-Y gastrojejunostomy, respectively. The ICG diffusion area along the gastric wall secured a resection margin of >28 mm. The ICG diffusion range can be used as a simple and easy method for determining the resection margin during gastrectomy using NIR imaging. MDPI 2022-10-25 /pmc/articles/PMC9658562/ /pubmed/36358639 http://dx.doi.org/10.3390/cancers14215223 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cho, Minah
Kim, Ki-Yoon
Park, Sung Hyun
Kim, Yoo Min
Kim, Hyoung-Il
Hyung, Woo Jin
Securing Resection Margin Using Indocyanine Green Diffusion Range on Gastric Wall during NIR Fluorescence-Guided Surgery in Early Gastric Cancer Patients
title Securing Resection Margin Using Indocyanine Green Diffusion Range on Gastric Wall during NIR Fluorescence-Guided Surgery in Early Gastric Cancer Patients
title_full Securing Resection Margin Using Indocyanine Green Diffusion Range on Gastric Wall during NIR Fluorescence-Guided Surgery in Early Gastric Cancer Patients
title_fullStr Securing Resection Margin Using Indocyanine Green Diffusion Range on Gastric Wall during NIR Fluorescence-Guided Surgery in Early Gastric Cancer Patients
title_full_unstemmed Securing Resection Margin Using Indocyanine Green Diffusion Range on Gastric Wall during NIR Fluorescence-Guided Surgery in Early Gastric Cancer Patients
title_short Securing Resection Margin Using Indocyanine Green Diffusion Range on Gastric Wall during NIR Fluorescence-Guided Surgery in Early Gastric Cancer Patients
title_sort securing resection margin using indocyanine green diffusion range on gastric wall during nir fluorescence-guided surgery in early gastric cancer patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9658562/
https://www.ncbi.nlm.nih.gov/pubmed/36358639
http://dx.doi.org/10.3390/cancers14215223
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