Dong Bo, Zhang Anyuan, Zhang Yuqiang, Ye Wei, Liao Lan, Li Zonglin
Department of General Surgery, The People's Hospital of Rongchang District, Chongqing, China.
Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Front Oncol. 2022 Oct 18;12:998159. doi: 10.3389/fonc.2022.998159. eCollection 2022.
Indocyanine green (ICG) imaging-guided lymphadenectomy has been introduced in gastric cancer (GC) surgery and its clinical value remains controversial. The aim of this study is to evaluate the efficacy of ICG fluorescence imaging-guided lymphadenectomy in radical gastrectomy for GC.
Studies comparing lymphadenectomy in radical gastrectomy between use and non-use of ICG fluorescence imaging up to July 2022 were systematically searched from PubMed, Web of Science, Embase and Cochrane Library. A pooled analysis was performed for the available data regarding the baseline features, the number of retrieved lymph nodes (LNs), the number of metastatic LNs and surgical outcomes as well as oncological outcomes. RevMan 5.3 software was used to perform the statistical analysis. Quality evaluation and publication bias were also conducted.
17 studies with a total of 2274 patients (1186 in the ICG group and 1088 in the control group) undergoing radical gastrectomy and lymphadenectomy were included. In the pooled analysis, the baseline features were basically comparable. However, the number of retrieved LNs in the ICG group was significantly more than that in the control group (MD = 7.41, 95% CI = 5.44 to 9.37, < 0.00001). No significant difference was found between the ICG and control groups in terms of metastatic LNs (MD = -0.05, 95% CI = -0.25 to 0.16, = 0.65). In addition, the use of ICG could reduce intraoperative blood loss (MD = -17.96, 95% CI = -27.89 to -8.04, = 0.0004) without increasing operative time ( = 0.14) and overall complications ( = 0.10). In terms of oncological outcomes, the use of ICG could reduce the overall recurrence rate (OR = 0.50; 95% CI 0.28-0.89; = 0.02) but could not increase the 2-year overall survival rate (OR = 1.25; 95% CI 0.72-2.18; = 0.43).
ICG imaging-guided lymphadenectomy is valuable for complete LNs dissection in radical gastrectomy for GC. However, more high-quality randomized controlled trials are needed to confirm this benefit.
吲哚菁绿（ICG）成像引导下的淋巴结清扫术已被引入胃癌（GC）手术，其临床价值仍存在争议。本研究旨在评估ICG荧光成像引导下的淋巴结清扫术在GC根治性胃切除术中的疗效。
从PubMed、科学网、Embase和Cochrane图书馆系统检索截至2022年7月比较ICG荧光成像使用与否在根治性胃切除术中淋巴结清扫情况的研究。对关于基线特征、回收淋巴结（LN）数量、转移LN数量、手术结果以及肿瘤学结果的可用数据进行汇总分析。使用RevMan 5.3软件进行统计分析。还进行了质量评估和发表偏倚分析。
纳入17项研究，共2274例患者（ICG组1186例，对照组1088例）接受根治性胃切除术和淋巴结清扫术。在汇总分析中，基线特征基本可比。然而，ICG组回收的LN数量显著多于对照组（MD = 7.41，95%CI = 5.
