Comparing ICG-Guided vs. Conventional Laparoscopic Lymphadenectomy in Gastric Cancer: A Systematic Review and...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Gastric cancer is a leading cause of cancer mortality globally.
• Lymphadenectomy is crucial for gastric cancer treatment, impacting survival.
• Indocyanine green (ICG) fluorescence guidance is a novel technique in laparoscopic surgery.

Purpose of the Study:

• To compare the effectiveness of ICG-guided laparoscopic lymphadenectomy versus conventional methods in gastric cancer.
• To evaluate surgical outcomes, including survival and lymph node retrieval, in gastric cancer patients.

Main Methods:

• Systematic review and meta-analysis adhering to PRISMA guidelines.
• Literature search across PubMed, Embase, and Cochrane Library databases (search end date: April 22, 2025).
• Quality assessment using ROB 2 and Newcastle-Ottawa Scale; data pooled using a random-effects model.

Main Results:

• Analysis of 3996 patients (1870 ICG-guided, 2126 non-ICG).
• ICG use significantly improved 1-year and 2-year overall survival (RR=1.04, 1.09).
• Greater lymph node retrieval (MD=6.00) and reduced intraoperative blood loss (MD=-14.44 mL) observed with ICG, with no significant difference in other outcomes.

Conclusions:

• ICG-guided surgery enhances short- and mid-term survival and lymph node retrieval in gastric cancer.
• The technique significantly reduces intraoperative blood loss.
• ICG-guided surgery offers clinical value by improving surgical outcomes without adverse effects on complications, operative time, or hospital stay.