Scholarlink

Background <p>Indocyanine green fluorescence-guided imaging (ICG-FGI) enhances surgical precision in rectal cancer procedures; however, it is technically demanding. This study evaluated the effects of ICG-FGI on the efficacy of lymphadenectomy during radical rectal cancer surgery.</p> Methods <p>This multi-center retrospective cohort study analyzed patients who underwent laparoscopic radical resection for rectal cancer between January 2021 and December 2024. The participants were stratified into two cohorts (ICG and non-ICG groups) using 1:1 propensity score matching to ensure balanced baseline characteristics. The ICG group received a submucosal ICG injection 24&#xa0;h preoperatively with intraoperative fluorescence laparoscopy navigation, whereas the non-ICG group underwent standard laparoscopy. Linear and logistic regression assessed determinants of lymph node yield and inferior mesenteric artery (IMA) lymph node metastasis, respectively. Diagnostic value of ICG-FGI in detecting IMA lymph node metastasis was assessed.</p> Result <p>Patients with rectal cancer were enrolled from two centers with comparable baseline characteristics. Propensity score matching (1:1) yielded 141 matched pairs (ICG vs. non-ICG) for comparative analysis. The ICG cohort exhibited superior lymph node resection (21 vs. 17, <i>P</i> &lt; 0.001) and higher number of patients with metastatic IMA lymph nodes detected (15.6 vs. 5.7%, <i>P</i> = 0.007). Multivariate linear regression analysis demonstrated that ICG-FGI was an independent predictor of enhanced nodal yield. Logistic regression analysis revealed that ICG-FGI technology significantly improved the detection rate of metastatic IMA lymph nodes. ICG-FGI sensitivity for detecting metastatic IMA station was 73.3%. Negative predictive value was 94.33% for non-fluorescent stations. Subgroup analysis revealed 75.00, 54.55, and 86.67% sensitivities for pT2, pT3, and pT4 tumors, respectively.</p> Conclusion <p>ICG-FGI improves the precision of lymph node dissection during rectal cancer surgery, enhances pathological staging accuracy via superior detection of metastatic IMA nodes, and guides personalized treatment strategies for advanced-stage disease.</p> Graphical abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Indocyanine green fluorescence-guided imaging enhances the efficiency and accuracy of inferior mesenteric artery lymph node dissection in rectal cancer

  • 期刊论文

  • 发表日期：

    2025年8月14日

查看全文
  • Bin Chen,
  • Shaoqing Zheng,
  • Liu Ning,
  • Zhang Jun,
  • Liying Zhong,
  • Jinfu Zhuang,
  • Xing Liu,
  • Guoxian Guan,
  • Yajun Zhao

摘要

Background

Indocyanine green fluorescence-guided imaging (ICG-FGI) enhances surgical precision in rectal cancer procedures; however, it is technically demanding. This study evaluated the effects of ICG-FGI on the efficacy of lymphadenectomy during radical rectal cancer surgery.

Methods

This multi-center retrospective cohort study analyzed patients who underwent laparoscopic radical resection for rectal cancer between January 2021 and December 2024. The participants were stratified into two cohorts (ICG and non-ICG groups) using 1:1 propensity score matching to ensure balanced baseline characteristics. The ICG group received a submucosal ICG injection 24 h preoperatively with intraoperative fluorescence laparoscopy navigation, whereas the non-ICG group underwent standard laparoscopy. Linear and logistic regression assessed determinants of lymph node yield and inferior mesenteric artery (IMA) lymph node metastasis, respectively. Diagnostic value of ICG-FGI in detecting IMA lymph node metastasis was assessed.

Result

Patients with rectal cancer were enrolled from two centers with comparable baseline characteristics. Propensity score matching (1:1) yielded 141 matched pairs (ICG vs. non-ICG) for comparative analysis. The ICG cohort exhibited superior lymph node resection (21 vs. 17, P < 0.001) and higher number of patients with metastatic IMA lymph nodes detected (15.6 vs. 5.7%, P = 0.007). Multivariate linear regression analysis demonstrated that ICG-FGI was an independent predictor of enhanced nodal yield. Logistic regression analysis revealed that ICG-FGI technology significantly improved the detection rate of metastatic IMA lymph nodes. ICG-FGI sensitivity for detecting metastatic IMA station was 73.3%. Negative predictive value was 94.33% for non-fluorescent stations. Subgroup analysis revealed 75.00, 54.55, and 86.67% sensitivities for pT2, pT3, and pT4 tumors, respectively.

Conclusion

ICG-FGI improves the precision of lymph node dissection during rectal cancer surgery, enhances pathological staging accuracy via superior detection of metastatic IMA nodes, and guides personalized treatment strategies for advanced-stage disease.

Graphical abstract