Journal of Gastric Cancer

  • 제18권2호
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  • Pages.161-171
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  • 2018
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Assessment of the Completeness of Lymph Node Dissection Using Near-infrared Imaging with Indocyanine Green in Laparoscopic Gastrectomy for Gastric Cancer

  • Kim, Tae-Han (Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kong, Seong-Ho (Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Park, Ji-Ho (Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Son, Yong-Gil (Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Huh, Yeon-Ju (Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Suh, Yun-Suhk (Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Lee, Hyuk-Joon (Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Yang, Han-Kwang (Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
  • 투고 : 2018.05.04
  • 심사 : 2018.06.25
  • 발행 : 2018.06.30
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초록

Purpose: This study assessed the feasibility of near-infrared (NIR) imaging with indocyanine green (ICG) in investigating the completeness of laparoscopic lymph node (LN) dissection for gastric cancer. Materials and Methods: Patients scheduled for laparoscopic gastrectomy for treating gastric cancer were enrolled in the study. After intraoperative submucosal ICG injection (0.05 mg/mL), LN dissection was performed under conventional laparoscopic light. After dissection, the LN stations of interest were examined under the NIR mode to locate any extra ICG-stained (E) tissues, which were excised and sent for pathologic confirmation. This technique was tested in 2 steps: infra-pyloric LN dissection (step 1) and review of all stations after proper radical node dissection (step 2). Results: In step 1, 15 patients who underwent laparoscopic pylorus-preserving gastrectomy (LPPG) and 15 patients who underwent laparoscopic distal gastrectomy (LDG) were examined. Seven and 2 E-tissues were obtained during LPPG and LDG, respectively. From the retrieved E-tissues, 1 and 0 tissue obtained during LPPG and LDG, respectively, was confirmed as LN. In step 2, 20 patients were enrolled (13 D1+ dissection and 7 D2 dissection). Six E-tissues were retrieved from 5 patients, and 1 tissue was confirmed as LN in the pathologic review. Overall, 15 E-tissues were detected and removed, and 2 tissues were confirmed as LNs in the pathologic review. Both nodes were from LN station #6, with 1 case each in the LDG and LPPG groups. Conclusions: NIR imaging may provide additional node detection during laparoscopic LN dissection for gastric cancer, especially in the infra-pyloric area.

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참고문헌

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  11. The short-term and long-term outcomes of indocyanine green tracer-guided laparoscopic radical gastrectomy in patients with gastric cancer vol.19, pp.1, 2018, https://doi.org/10.1186/s12957-021-02385-1