吲哚菁绿荧光淋巴结图谱在腹腔镜右半结肠切除术中的临床效果：一项前瞻性病例对照研究
Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case-Control Study.
作者信息
Son Gyung Mo, Yun Mi Sook, Lee In Young, Im Sun Bin, Kim Kyung Hee, Park Su Bum, Kim Tae Un, Shin Dong-Hoon, Nazir Armaan M, Ha Gi Won
机构信息
Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea.
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea.
出版信息
Cancers (Basel). 2023 Oct 10;15(20):4927. doi: 10.3390/cancers15204927.
BACKGROUND
The distinction between D3 lymph nodes and actual lymphatic pathways in primary tumors can be difficult during surgery, making it challenging to confirm the completeness of D3 lymph node dissection. Fluorescence lymph node mapping (FLNM) is a promising method for lymph node visualization.
PURPOSE
This study aimed to assess whether FLNM enhances the effectiveness of D3 lymph node dissection in patients with right-sided colon cancer.
METHODS
Endoscopic submucosal indocyanine green injection were performed on the distal margin of the colon cancer. In an FLNM group, the lymphatic drainage pathway and distribution of D3 lymph nodes were explored. Pathological evaluations were conducted for the fluorescent D3 and non-fluorescent D3 lymph nodes.
RESULTS
The FLNM group showed a significantly higher number of harvested lymph nodes in the D3 area. In stage III patients, the proportion of D3 lymph node metastasis was significantly higher in the FLNM group. The harvested D3 lymph node count showed a proportional correlation with a metastatic lymph node count of up to 15.
CONCLUSION
FLNM could be considered a promising new strategy to potentially increase harvested D3 lymph node counts in colon cancer surgery.
背景
在手术过程中，区分原发性肿瘤中的D3淋巴结与实际淋巴引流途径可能具有挑战性，这使得确认D3淋巴结清扫的完整性具有挑战性。荧光淋巴结图谱（FLNM）是一种很有前景的淋巴结可视化方法。
目的
本研究旨在评估FLNM是否能提高右侧结肠癌患者D3淋巴结清扫的有效性。
方法
在结肠癌远端边缘进行内镜下黏膜下注射吲哚菁绿。在FLNM组中，探索D3淋巴结的淋巴引流途径和分布。对荧光D3淋巴结和非荧光D3淋巴结进行病理评估。
结果
FLNM组在D3区域收获的淋巴结数量明显更多。在III期患者中，FLNM组D3淋巴结转移的比例明显更高。收获的D3淋巴结计数与转移淋巴结计数呈比例相关，最高可达15个。
结论
FLNM可被视为一种有前景的新策略，有可能增加结肠癌手术中收获的D3淋巴结数量。
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