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Function-Preserving Curative Gastrectomy Guided by ICG Fluorescence Imaging for Early Gastric Cancer

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ICG Fluorescence Imaging and Navigation Surgery

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Abstract

Recently, the SNNS study provided proof of the sentinel node (SN) concept in gastric cancer. The result highlights the credibility of the clinical application of SN biopsy for indicating function-preserving curative surgery in early gastric cancer. In the SNNS study, combination mapping with technetium-99 m tin colloid and isosulfan blue was used and has been adopted as a temporary standard. Nevertheless, blue dye deteriorates quickly, and radioactive colloids exhibit a shine-through effect during gamma probe detection of hot nodes in the surgical field. These limitations increase the difficulty in performing laparoscopic SN biopsy. In contrast, ICG seemed to be a promising tracer candidate for laparoscopic SN biopsy. ICG fluorescence imaging was developed after the recent invention of Photodynamic Eye. The advantages of ICG fluorescence imaging are as follows: obvious visualization, easier detection of bright nodes and lymphatic canals than with the naked eye, very high sensitivity to detect minute concentrations of ICG, and signal stability. ICG fluorescence imaging for SN biopsy might be feasible in both open and laparoscopic surgery for early gastric cancer; therefore, laparoscopic function-preserving curative gastrectomy would be a good alternative to the commonly used D1+ gastrectomy for patients with node-negative gastric cancer.

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Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan

    Shinichi Kinami

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  1. Shinichi Kinami
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Correspondence to Shinichi Kinami .

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Editors and Affiliations

  1. Department of Surgery, Seiwa Memorial Hospital, Sapporo, Hokkaido, Japan

    Mitsuo Kusano

  2. Hepato-Biliary-Pancreatic Surgery Divisi, University of Tokyo, TOKYO 113-8655, Tokyo, Japan

    Norihiro Kokudo

  3. Department of Breast Surgery Graduate Sc, Kyoto University, Kyoto, Kyoto, Japan

    Masakazu Toi

  4. Department of Surgery, Hirakata Hospital, Kansai Medical University, Hirakata, Osaka, Japan

    Masaki Kaibori

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Kinami, S. (2016). Function-Preserving Curative Gastrectomy Guided by ICG Fluorescence Imaging for Early Gastric Cancer. In: Kusano, M., Kokudo, N., Toi, M., Kaibori, M. (eds) ICG Fluorescence Imaging and Navigation Surgery. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55528-5_13

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  • DOI: https://doi.org/10.1007/978-4-431-55528-5_13

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  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-55527-8

  • Online ISBN: 978-4-431-55528-5

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