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Fluorescence-guided laparoscopic lymph node biopsy for lymphoma: the FLABILY study.
Marco Casaccia1,2, Giovanni Alemanno3, Paolo Prosperi3
1Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy. marco.casaccia@unige.it.
Updates in Surgery
|June 14, 2024
Summary
Fluorescence-guided laparoscopic lymph node biopsy using Indocyanine green (ICG) is a safe and effective method for diagnosing and staging lymphoproliferative diseases. This technique successfully identified pathological lymph nodes in 86% of patients, aiding diagnosis in 98% of cases.
Area of Science:
- Surgical Oncology
- Medical Imaging
- Hematology
Background:
- Laparoscopic lymph node biopsy using Indocyanine green (ICG) has not been reported for lymphoproliferative diseases.
- Preliminary data from the FLABILY study evaluated fluorescence-guided laparoscopic lymph node biopsy (FGLLB) in this context.
Purpose of the Study:
- To assess the feasibility and efficacy of FGLLB with ICG for diagnosing and staging intra-abdominal lymphoproliferative diseases.
- To evaluate the safety and diagnostic yield of this novel technique.
Main Methods:
- Retrospective analysis of 50 patients undergoing FGLLB between June 2022 and February 2024.
- ICG administered preoperatively via inguinal, perilesional, or intravenous injection.
- Biopsies aimed at diagnosis (25 patients) or staging (25 patients) of lymphoproliferative disease.
Main Results:
- The median procedure duration was 65 minutes, with one conversion due to bleeding.
- Median hospitalization was 1 day, with two unrelated postoperative complications.
- Fluorescence was achieved in 86% of patients, with higher rates in sub-mesocolic lymph nodes.
- FGLLB provided necessary diagnostic information in 98% of cases.
Conclusions:
- ICG-guided FGLLB is a simple, safe, and effective method for detecting pathological lymph nodes in suspected intra-abdominal lymphoma.
- This technique offers a promising new approach for the diagnosis and staging of lymphoproliferative diseases.
- Further studies with larger cohorts are warranted to confirm efficacy.
