Picchetto Andrea, Seeliger Barbara, La Rocca Stefania, Barberio Manuel, D'Ambrosio Giancarlo, Marescaux Jacques, Diana Michele
General and Colorectal Surgery Division, Department of Cardiothoracic, Vascular Surgery and Organ Transplantation, Policlinico Umberto I University Hospital, Sapienza University of Rome, Viale del Policlinico 155, Rom, Italien.
Institute of Image-Guided Surgery, IHU-Strasbourg, Straßburg, Frankreich.
Chirurg. 2019 Nov;90(11):891-898. doi: 10.1007/s00104-019-01039-z.
A correct lymph node (LN) staging is essential in oncological surgery. Indocyanine green (ICG) near-infrared fluorescence (NIRF) guided sentinel lymph node (SLN) navigation is a relatively novel technique. The aim of this review is to analyze the impact of ICG-NIRF on identification of LN metastases of gastrointestinal tumors. The Scopus and PubMed/MEDLINE literature databases were searched and 20 studies were included. The ICG-NIRF navigation of LN has been shown to enable and improve LN detection in gastrointestinal tumors; however, the mean detection, sensitivity, accuracy and false negative rates show substantial variation. This could be due to both the heterogeneous techniques applied and to the low retention of ICG by lymph nodes. Fluorescence imaging to identify LN drainage is a promising tool to improve oncological outcomes. Nonetheless, the technique requires further development in terms of hardware, software and fluorophores, which are currently being investigated.
正确的淋巴结（LN）分期在肿瘤外科手术中至关重要。吲哚菁绿（ICG）近红外荧光（NIRF）引导的前哨淋巴结（SLN）导航是一种相对新颖的技术。本综述的目的是分析ICG-NIRF对胃肠道肿瘤LN转移灶识别的影响。检索了Scopus和PubMed/MEDLINE文献数据库，纳入了20项研究。ICG-NIRF引导的LN导航已被证明能够实现并改善胃肠道肿瘤中LN的检测；然而，平均检测率、敏感性、准确性和假阴性率显示出很大差异。这可能是由于所应用技术的异质性以及淋巴结对ICG的低滞留率。通过荧光成像识别LN引流是改善肿瘤治疗效果的一种有前景的工具。尽管如此，该技术在硬件、软件和荧光团方面仍需要进一步发展，目前正在对此进行研究。
