Abstract
The applications of indocyanine green (ICG) fluorescence imaging (IFI) for fluorescent-guided surgery have been expanding. Here we assessed the use of IFI in gastrointestinal tract surgeries. We first evaluated the feasibility of sentinel lymph node (SLN) mapping guided by IFI in gastrointestinal cancers. Twenty-two gastric cancer patients and 26 colorectal cancer patients who had undergone standard surgical resection were enrolled. The SLN detection rate in our preliminary study was 90.9 % and the mean number of SLNs was 3.6 in the gastric cancer patients, and the corresponding values in the colorectal cancer patients were 88.5 % and 2.6. Among the gastric cancer patients, the accuracy was 88.9 % and the false-negative rate was 33.3 %. Secondly, we assessed the efficacy of a new method for tattooing the tumor location using IFI instead of India ink. We succeeded in the ICG marking of early-stage stomach cancer and colon cancer, and our results may lead to the establishment of a new marking procedure instead of the conventional India ink and clipping methods. Lastly, we evaluated whether an IFI method of harvesting lymph nodes (LNs) from resected specimens could improve the accuracy of LN staging. ICG fluorescence-labeled LNs were found even though the ICG solution was injected ex vivo. The IFI method thus improved the LN harvest from resected specimens. This method will provide precise evaluations of the pathological status of LNs.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Veronesi U, Paganelli G, Viale G et al (2006) Sentinel-lymph-node biopsy as a staging procedure in breast cancer: update of a randomised controlled study. Lancet Oncol 7(12):983–990
Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, Foshag LJ, Cochran A (1992) Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 127(4):392–399
Fattahi AS, Tavassoli A, Rohbakhshfar O et al (2014) Can methylene blue dye be used as an alternative to patent blue dye to find the sentinel lymph node in breast cancer surgery? J Res Med Sci 19(10):918–922
Ahmed M, Purushotham AD, Horgan K et al (2015) Meta-analysis of superficial versus deep injection of radioactive tracer and blue dye for lymphatic mapping and detection of sentinel lymph nodes in breast cancer. Br J Surg 102(3):169–181
Singh S1, Arif A, Fox C, Basnyat P (2006) Complication after pre-operative India ink tattooing in a colonic lesion. Dig Surg 23(5–6):303
Kusano M, Yasuda D, Watanabe M et al (2008) Novel fluorescence endoscope for minimally invasive surgery SAGES (Society of American Gastrointestinal Endoscopic Surgeons) 2008. Emergency technology poster session proceedings, vol 2, p 304
Saito H, Fukumoto Y, Osaki T, Fukuda K et al (2007) Prognostic significance of level and number of lymph node metastases in patients with gastric cancer. Ann Surg Oncol 14:1688–1693
Karpeh MS, Leon L, Klimstra D, Brennan MF (2000) Lymph node staging in gastric cancer: is location more important than Number? An analysis of 1,038 patients. Ann Surg 232:362–371
Espin F, Bianchi A, Llorca S et al (2012) Metastatic lymph node ratio versus number of metastatic lymph nodes as a prognostic factor in gastric cancer. Eur J Surg Oncol 38:497–502
Kusano M, Tajima Y, Yamazaki K et al (2008) Sentinel node mapping guided by indocyanine green fluorescence imaging: a new method for sentinel node navigation surgery in gastrointestinal cancer. Dig Surg 25(2):103–108
Tajima Y, Yamazaki K, Masuda Y et al (2009) Sentinel node mapping guided by indocyanine green fluorescence imaging in gastric cancer. Ann Surg 249:58–62
Kitagawa Y, Takeuchi H, Takagi Y et al (2013) Sentinel node mapping for gastric cancer: a prospective multicenter trial in Japan. J Clin Oncol 31:3704–3710
Takeuchi H1, Kitagawa Y (2015) Sentinel lymph node biopsy in gastric cancer. Cancer J 21(1):21–24
Nimura H, Narimiya N, Mitsumori N et al (2004) Infrared ray electronic endoscopy combined with indocyanine green injection for detection of sentinel nodes of patients with gastric cancer. Br J Surg 91:575–579
Tajima Y, Murakami M, Yamazaki K et al (2010) Sentinel node mapping guided by indocyanine green. Ann Surg Oncol 17(7):1787–1793
Cahill RA, Anderson M, Wang LM et al (2012) Near-infrared (NIR) laparoscopy for intraoperative lymphatic road-mapping and sentinel node identification during definitive surgical resection of early-stage colorectal neoplasia. Surg Endosc 26(1):197–204
Miyoshi N, Ohue M, Noura S et al (2009) Surgical usefulness of indocyanine green as an alternative to India ink for endoscopic marking. Surg Endosc 23(2):347–351
Sobin LHGM, Wittekind C (2009) TNM classification of malignant tumors, 7th edn. Wiley-Blackwell, Oxford
Japanese Gastric Cancer A (2011) Japanese classification of gastric carcinoma, 3rd English Edition. Gastric Cancer 14:101–112
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer Japan
About this chapter
Cite this chapter
Kusano, M. et al. (2016). Fluorescent Navigation Surgery for Gastrointestinal Tract Cancers: Detection of Sentinel Nodes, Tumor Tattooing, and Harvesting of Lymph Nodes. 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_14
Download citation
DOI: https://doi.org/10.1007/978-4-431-55528-5_14
Published:
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-55527-8
Online ISBN: 978-4-431-55528-5
eBook Packages: MedicineMedicine (R0)