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Subserosal Indocyanine Green Plus Submucosal Carbon Nanoparticle Navigated Laparoscopic Gastrectomy (DANCE-01): a Cohort Study

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Indocyanine green (ICG) and carbon nanoparticle (CN) have been widely used for radical gastrectomy. However, synchronous application of ICG and CN in gastrectomy has not been tried yet. For the first time, we herein reported a novel strategy using dual tracers in laparoscopic radical gastrectomy.

Methods

This is a single-center, single-armed, prospective study. For each qualified patient, submucosal CN was injected the day before surgery, and subserosal ICG was injected immediately before surgery. Standard D2 laparoscopic gastrectomy and lymph node examination were subsequently performed. Demographics, lymph nodes (LNs) and postoperative outcome were collected for analysis. To analyze the safety and efficacy of this novel strategy, two contemporary historic control groups using single tracer were established.

Results

A total of 60 patients underwent dual tracer laparoscopic gastrectomy and were divided into distal (n = 41) and total (n = 19) groups. An average of 53.3 and 62.2 LNs was harvested from two groups, respectively. The average operation duration was 213.3 and 250.0 min, and intra-operative blood loss was 100.2 ml and 94.7 ml. None received combined organ resection. Margin negativity and R0 resection were achieved in all patients. Three (7.3%) complications occurred in distal group. None required second operation or deceased. Postoperative hospitalization was 9.7 and 9.6 days, respectively. Compared to single tracer, more LNs (p < 0.01), shorter operation time (p < 0.01), less blood lost (p < 0.01) and accelerated postoperative recovery (p < 0.01) were observed in dual tracer group.

Conclusions

We propose a novel, feasible and safe tracing strategy for laparoscopic gastrectomy.

Clinical Trial Registration

Chinese Clinical Trial Registry (ChiCTR2100051309).

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Data Availability

All raw data is available from the corresponding author upon reasonable request.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (82172645), Natural Science Foundation of Jiangsu Province for Outstanding Young Scholars (BK20200052), Jiangsu Provincial Key Research and Development Program (BE2022667 and BE2022753), Key Project of Nanjing Health Commission (ZKX21013), Bethune Charitable Foundation (05002), and Clinical Trials from the Affiliated Drum Tower Hospital Medical School of Nanjing University (2021-LCYJ-MS-09 and 2021-LCYJ-PY-17).

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Author notes

  1. Song Liu, Shichao Ai and Peng Song contributed equally to this work.

Authors and Affiliations

  1. Division of Gastric Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan RD, Nanjing, 210008, China

    Song Liu, Shichao Ai, Peng Song, Meng Wang, Xiaofeng Lu & Wenxian Guan

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  1. Song Liu
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Correspondence to Wenxian Guan.

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Supplementary file1 (DOCX 33 KB)

Supplementary Video 1 Lymph node examination using fluorescence examination system (Real-IGS FLI-10B) after gastrectomy. (MP4 65176 KB)

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Liu, S., Ai, S., Song, P. et al. Subserosal Indocyanine Green Plus Submucosal Carbon Nanoparticle Navigated Laparoscopic Gastrectomy (DANCE-01): a Cohort Study. J Gastrointest Surg 27, 2068–2075 (2023). https://doi.org/10.1007/s11605-023-05756-z

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