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Detection of indocyanine green fluorescence to determine tumor location during laparoscopic gastrectomy for gastric cancer: Results of a prospective study
- Source :
- Asian Journal of Endoscopic Surgery. 13:160-167
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- INTRODUCTION In laparoscopic gastrectomy, a method to locate the margin of an early-stage cancerous lesion that is invisible from the serosal surface and impalpable during laparoscopic procedures is needed to determine an appropriate transection line. We conducted a prospective study to develop a new marking method using preoperative submucosal injection of indocyanine green (ICG). METHODS Patients undergoing laparoscopic gastrectomy for T1 gastric cancer were recruited. The first 11 patients comprised the learning set and the subsequent 18 patients the validation set. ICG was endoscopically injected in the submucosal layer of the stomach approximately 1 cm away from the tumor edge 1 or 3 days before surgery. The diameters of the visualized ICG were compared with those of a conventional marking method using India ink in 10 historical controls. RESULTS In the learning set, the optimal amount of ICG was determined to be 0.1 mL at a concentration of 0.5 mg/mL. In the validation set, the same procedure was repeated. No technical problems or adverse reactions related to ICG injection were observed. In all cases, ICG was successfully detected, and negative surgical margins were pathologically confirmed. The mean long diameter of the visualized ICG fluorescence measured at the mucosal surface of the stomach was significantly smaller in the current study than in the historical controls in whom India ink was used (21 vs 52 mm, P
- Subjects :
- Adult
Indocyanine Green
Male
medicine.medical_specialty
genetic structures
Adenocarcinoma
Fluorescence
Lesion
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Gastrectomy
Stomach Neoplasms
medicine
Humans
Prospective Studies
Coloring Agents
Prospective cohort study
Aged
Aged, 80 and over
business.industry
Stomach
Margins of Excision
Laparoscopic gastrectomy
Cancer
General Medicine
Middle Aged
medicine.disease
eye diseases
Surgery
Early Gastric Cancer
body regions
medicine.anatomical_structure
chemistry
030220 oncology & carcinogenesis
Feasibility Studies
Female
Laparoscopy
030211 gastroenterology & hepatology
medicine.symptom
business
Nuclear medicine
Indocyanine green
Indocyanine green fluorescence
Subjects
Details
- ISSN :
- 17585910 and 17585902
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Asian Journal of Endoscopic Surgery
- Accession number :
- edsair.doi.dedup.....e5da54a5ee0ec8388f7f152e199d697e