Near-Infrared Imaging Using Indocyanine Green for Laparoscopic Lateral Pelvic Lymph Node Dissection for Clinical...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Medical Imaging

Background:

• The efficacy of near-infrared (NIR) imaging with indocyanine green (ICG) in laparoscopic lateral pelvic lymph node dissection (LPLND) requires further investigation.
• Accurate lymph node assessment is crucial for staging and treatment planning in rectal cancer.

Purpose of the Study:

• To evaluate whether NIR imaging enhances the total number of harvested lateral pelvic lymph nodes during LPLND.
• To assess the impact of NIR imaging on operative time, blood loss, and postoperative complications.

Main Methods:

• Retrospective, multi-institutional study involving patients with middle-low rectal cancer (clinical stage II-III) undergoing LPLND.
• Propensity score matching was used to compare outcomes between patients who underwent LPLND with and without NIR imaging (ICG).
• Data collected included total harvested lymph nodes, operative time, intraoperative blood loss, and postoperative complication rates.

Main Results:

• A total of 172 patients were included; 58 were matched in each group (NIR vs. non-NIR).
• The NIR group showed a significantly higher number of harvested lymph nodes (14 vs. 9) compared to the non-NIR group.
• Operative time was longer in the NIR group (426 vs. 369 min), but intraoperative blood loss was significantly lower (13 vs. 110 mL). No significant difference in postoperative complications was observed.

Conclusions:

• Laparoscopic LPLND combined with NIR imaging (ICG) can increase the total number of harvested lateral pelvic lymph nodes.
• This technique appears safe and effective, without negatively impacting functional preservation or increasing complication rates.
• NIR imaging offers a valuable adjunct for improving lymph node yield in LPLND for rectal cancer.