Indocyanine Green Tracer-Guided Lymph Node Retrieval During Radical Dissection in Gastric Cancer Surgery
Mené sur 258 patients atteints d'un cancer de l'estomac traité par gastrectomie laparoscopique (âge moyen : 57,8 ans ; 85 femmes), cet essai évalue l'efficacité, du point de vue du nombre total de ganglions collectés, et la sécurité d'une lymphadénectomie D2 intra-opératoire guidée à l'aide de l'imagerie par fluorescence en proche infrarouge avec utilisation du vert d'indocyanine
Chen and colleagues performed a randomized controlled clinical trial to determine the usefulness of an indocyanine green (ICG) tracer for lymph node dissection during radical gastric cancer surgery. This single-institution study was performed in a tertiary referral center, in which more than 800 gastric resections are performed every year.Two hundred fifty-eight patients with T1 to T4a gastric cancer were randomized to undergo either a conventional gastrectomy (129 patients) or an ICG tracer-guided laparoscopic D2 gastrectomy (129 patients). The ICG was injected endoscopically in the peritumoral submucosa the day before the operation. The primary end point of the study was the number of retrieved lymph nodes; the secondary end points were the noncompliance rate (defined as the absence of lymph nodes from more than 1 standard lymph node station), morbidity, and mortality.
JAMA Surgery , commentaire, 2019