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Related Experiment Video

Updated: Sep 8, 2025

Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
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Fluorescence lymph node mapping using ICG improves lateral lymph node dissection for mid-low rectal cancer: a

W Qiu1, H Niu2, G Hu1

  • 1Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.

Techniques in Coloproctology
|July 13, 2025
PubMed
Summary

Indocyanine green (ICG)-assisted lateral lymph node dissection (LLND) improved lymph node harvest and reduced hospital stays for rectal cancer patients. This technique enhances surgical outcomes without increasing complications.

Keywords:
Fluorescence-guide lymph node mappingIndocyanine greenLateral lymph nodePropensity score matchingRectal cancer

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Area of Science:

  • Surgical Oncology
  • Medical Imaging
  • Rectal Cancer Treatment

Background:

  • Lateral lymph node metastasis (LLNM) poses diagnostic and therapeutic challenges in rectal cancer.
  • Current treatment strategies require optimization for patients with LLNM.

Purpose of the Study:

  • To evaluate the effectiveness of indocyanine green (ICG)-assisted lymph node mapping with near-infrared imaging (NIRI) in enhancing lateral lymph node dissection (LLND).
  • To assess the impact of ICG-LLND on lymph node categorization and surgical outcomes in mid-low rectal cancer patients.

Main Methods:

  • Submucosal ICG injection at the distal rectal cancer margin.
  • Laparoscopic NIRI system used for ICG-LLND to visualize lymphatic pathways and lateral lymph nodes (LLNs).
  • Pathological evaluation of harvested lymph nodes in both ICG-LLND and control groups.

Main Results:

  • ICG-LLND group showed significantly shorter postoperative hospital stays.
  • Higher total and lateral lymph node harvest in the ICG-LLND group, including obturator and internal iliac regions.
  • Increased detection of positive lymph nodes in obturator and internal iliac regions in the ICG-LLND group.
  • No significant difference in blood loss or operating time; fewer anastomotic leakage cases observed.

Conclusions:

  • ICG-LLND significantly improves lateral lymph node harvest, especially in the obturator region.
  • This technique leads to shorter postoperative hospital stays without increasing complications.
  • ICG-LLND shows potential to enhance surgical outcomes for patients undergoing lymph node dissection for rectal cancer.