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Sentinel Node Mapping Guided by Indocyanine Green Fluorescence Imaging During Laparoscopic Surgery in Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Indocyanine green (ICG) fluorescence imaging has recently been reported as a new method for sentinel node (SN) mapping in several types of cancers. In this study, we determined the possible usefulness of SN mapping guided by ICG fluorescence imaging during laparoscopy-assisted gastrectomy (LAG) for gastric cancer.

Methods

Our series consisted of 77 patients with cT1- or cT2-stage gastric cancer who had undergone LAG (LAG group; 38 patients) or conventional open gastrectomy (OG group; 39 patients). Intraoperative SN mapping guided by ICG fluorescence imaging was conducted with a charge-coupled device camera with a light-emitting diode as the light source and a cut filter as the detector.

Results

The detection rate and mean number of fluorescent nodes (FNs) were 94.7% and 7.9, respectively, in the LAG group, and 94.9% and 7.2, respectively, in the OG group. The accuracy and false-negative rates were 97.2% (35 of 36 cases) and 25% (1 of 4), respectively, in the LAG group, and 91.9% (34 of 37) and 23.1% (3 of 13), respectively, in the OG group. Among 33 LAG group patients and 27 OG group patients without FN metastasis, lymph node metastasis was found only in non-SNs located in the same lymphatic basin as the detected FNs.

Conclusions

SN mapping guidance by ICG fluorescence imaging could be useful for predicting the lymph node metastasis in gastric cancer, even during LAG. Our data suggest that dissection of the lymphatic basin containing FNs with laparoscopic surgery may be a promising approach as a new type of minimally invasive surgery for patients with cT1- or cT2-stage gastric cancer having no metastasis in FNs.

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Acknowledgment

This work was supported by Grant-in-Aid for Scientific Research, Japan Society for the Promotion of Science.

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Authors and Affiliations

  1. Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan

    Yusuke Tajima MD, PhD, Masahiko Murakami MD, PhD, Kimiyasu Yamazaki MD, PhD, Yuki Masuda MD, PhD, Masanori Kato MD, Atsushi Sato MD, Satoru Goto MD, PhD, Koji Otsuka MD, Takashi Kato MD, PhD & Mitsuo Kusano MD, PhD

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  1. Yusuke Tajima MD, PhD
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  2. Masahiko Murakami MD, PhD
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  3. Kimiyasu Yamazaki MD, PhD
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  4. Yuki Masuda MD, PhD
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  5. Masanori Kato MD
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  6. Atsushi Sato MD
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  7. Satoru Goto MD, PhD
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  8. Koji Otsuka MD
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  9. Takashi Kato MD, PhD
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  10. Mitsuo Kusano MD, PhD
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Correspondence to Yusuke Tajima MD, PhD.

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Tajima, Y., Murakami, M., Yamazaki, K. et al. Sentinel Node Mapping Guided by Indocyanine Green Fluorescence Imaging During Laparoscopic Surgery in Gastric Cancer. Ann Surg Oncol 17, 1787–1793 (2010). https://doi.org/10.1245/s10434-010-0944-0

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  • DOI: https://doi.org/10.1245/s10434-010-0944-0

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