Invited Lecture(JSGS)
Fri. November 3rd   11:30 - 12:00   Room 12: Kobe International Conference Center Main Hall
Invited Lecture14
Application and research progress of indocyanine green fluorescence tracer technique in minimally invasive surgery for gastric cancer
Chang-Ming Huang
Department of Gastric Surgery, Fujian Medical University Union Hospital
Indocyanine green (ICG) is a kind of near-infrared dye. We can display ICG imaging in high definition systems with special filters. For early gastric cancer, ICG imaging can identify tumor locations; in addition, it can determine the surgical margin to ensure adequate resection. Sentinel lymph nodes in early gastric cancer can also be detected by ICG imaging, which is convenient for biopsy. Our center carried out a randomized, controlled study of Safety and Efficacy of Indocyanine Green Tracer-Guided Lymph Node Dissection During Laparoscopic Radical Gastrectomy in Patients With Gastric Cancer, which was published in JAMA SURGERY in 2020. Our results showed that the number of lymph node retrieved in the ICG group was significantly more than those retrieved in the non-ICG group. ICG can noticeably improve the number of lymph node dissections and reduce lymph node noncompliance without increased complications in patients undergoing D2 lymphadenectomy. Of note, ICG can be used to determine the presence of a residual fluorescent lymph node after completing all lymph node dissections. We also reported the Long-Term Outcomes of Indocyanine Green Fluorescence Imaging-Guided Laparoscopic Lymphadenectomy for Gastric Cancer. In this trial, ICG fluorescence imaging-guided lymphadenectomy shows substantial long-term oncological efficacy compared with conventional lymphadenectomy. We suggest that ICG-guided laparoscopic radical lymphadenectomy for GC be routinely performed. ICG is easy and effective to use. It can be used routinely in laparoscopic radical gastrectomy for gastric cancer. The technique has a good visualization of lymph nodes and a high detection rate of lymph nodes, and can reduce the non-compliance rate of lymph nodes, which is conducive to improving the thoroughness of lymph node dissection. The clinical efficacy of ICG-guided laparoscopic lymphadenectomy for gastric cancer needs to be confirmed by further prospective clinical studies.
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