Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A...

Area of Science:

• Surgical oncology
• Medical imaging
• Gastrointestinal surgery

Background:

• Differentiating D3 lymph nodes from lymphatic pathways is challenging during colon cancer surgery.
• Confirming complete D3 lymph node dissection can be difficult.
• Fluorescence lymph node mapping (FLNM) offers potential for improved lymph node visualization.

Purpose of the Study:

• To evaluate if FLNM enhances D3 lymph node dissection effectiveness in right-sided colon cancer.
• To assess the impact of FLNM on lymph node yield and metastasis detection.

Main Methods:

• Indocyanine green injection for endoscopic submucosal administration.
• Exploration of lymphatic drainage and D3 lymph node distribution using FLNM.
• Pathological evaluation of fluorescent and non-fluorescent D3 lymph nodes.

Main Results:

• The FLNM group yielded significantly more D3 lymph nodes.
• Stage III patients in the FLNM group showed a higher proportion of D3 lymph node metastasis.
• Harvested D3 lymph node count correlated with metastatic lymph node count up to 15.

Conclusions:

• FLNM is a promising strategy for increasing harvested D3 lymph node counts in colon cancer surgery.
• FLNM may improve the accuracy and completeness of D3 lymph node dissection.