Oncologic outcomes of ICG fluorescence imaging guided laparoscopic right hemicolectomy
EAES Academy. Watanabe J. 07/05/22; 363019; P063
Jun Watanabe
Contributions
Contributions
Abstract
Aim:
To investigate the oncologic outcomes of CME using intraoperative lymphatic flow evaluation by ICG fluorescence imaging (ICG-FI) in laparoscopic right hemicolectomy (LRHC) for right colon cancer.
Methods:
From January 2009 to December 2020, 921 patients who underwent D3 dissection for right-sided colon cancer except Stage IV were included. ICG-FI guided LRHC (ICG group) was performed in 233 cases, and LRHC without ICG-FI (non-ICG group) was performed in 688 cases. We compared and examined the oncologic outcomes after Propensity Score matching with age, gender, BMI, ASA-PS, tumor localization, and cStage as covariates.
Results:
231 patients in the ICG group and 231 patients in the non-ICG group were selected. The median operative time was 174 vs 175 minutes, which was not different (p = 0.737), and the median blood loss was 0 vs 5 ml, which was significantly smaller in the ICG group (p <0.001). The incidence of complications of Clavien-Dindo classification Grade 2 or higher was 8.2 vs 12.1% (p = 0.109), which was not different. The median number of lymph node dissections is 6 vs 4 (p <0.001) for the main lymph nodes, 7 vs 6 (p = 0.032) for the intermediate lymph nodes, and 31 vs 27 (p = 0.047) in total, which were significantly more in the ICG group. The 3-year recurrence-free survival by stage is Stage I: 100 vs 100%, Stage II: 87.4 vs 90.5% (p = 0.451), Stage III: 78.2 vs 73.5% (p = 0.709), and the 3-year overall survival is Stage I: 96.8 vs 100% (p = 0.091), Stage II: 92.3 vs 94.3% (p = 0.325), Stage III: 95.8 vs 87.6% (p = 0.364), and there was no significant difference between the two groups. The recurrence type (liver / lung / peritoneal dissemination / lymph node / local / other) was 7/6/2/1/2/1 vs 7/9/7/1/0/1, and there was no difference between the two groups.
Conclusion:
Although ICG-FI guided CME may be able to dissect the main and intermediate lymph nodes more precisely, there was no difference in mid-term results or recurrence type.
To investigate the oncologic outcomes of CME using intraoperative lymphatic flow evaluation by ICG fluorescence imaging (ICG-FI) in laparoscopic right hemicolectomy (LRHC) for right colon cancer.
Methods:
From January 2009 to December 2020, 921 patients who underwent D3 dissection for right-sided colon cancer except Stage IV were included. ICG-FI guided LRHC (ICG group) was performed in 233 cases, and LRHC without ICG-FI (non-ICG group) was performed in 688 cases. We compared and examined the oncologic outcomes after Propensity Score matching with age, gender, BMI, ASA-PS, tumor localization, and cStage as covariates.
Results:
231 patients in the ICG group and 231 patients in the non-ICG group were selected. The median operative time was 174 vs 175 minutes, which was not different (p = 0.737), and the median blood loss was 0 vs 5 ml, which was significantly smaller in the ICG group (p <0.001). The incidence of complications of Clavien-Dindo classification Grade 2 or higher was 8.2 vs 12.1% (p = 0.109), which was not different. The median number of lymph node dissections is 6 vs 4 (p <0.001) for the main lymph nodes, 7 vs 6 (p = 0.032) for the intermediate lymph nodes, and 31 vs 27 (p = 0.047) in total, which were significantly more in the ICG group. The 3-year recurrence-free survival by stage is Stage I: 100 vs 100%, Stage II: 87.4 vs 90.5% (p = 0.451), Stage III: 78.2 vs 73.5% (p = 0.709), and the 3-year overall survival is Stage I: 96.8 vs 100% (p = 0.091), Stage II: 92.3 vs 94.3% (p = 0.325), Stage III: 95.8 vs 87.6% (p = 0.364), and there was no significant difference between the two groups. The recurrence type (liver / lung / peritoneal dissemination / lymph node / local / other) was 7/6/2/1/2/1 vs 7/9/7/1/0/1, and there was no difference between the two groups.
Conclusion:
Although ICG-FI guided CME may be able to dissect the main and intermediate lymph nodes more precisely, there was no difference in mid-term results or recurrence type.
Aim:
To investigate the oncologic outcomes of CME using intraoperative lymphatic flow evaluation by ICG fluorescence imaging (ICG-FI) in laparoscopic right hemicolectomy (LRHC) for right colon cancer.
Methods:
From January 2009 to December 2020, 921 patients who underwent D3 dissection for right-sided colon cancer except Stage IV were included. ICG-FI guided LRHC (ICG group) was performed in 233 cases, and LRHC without ICG-FI (non-ICG group) was performed in 688 cases. We compared and examined the oncologic outcomes after Propensity Score matching with age, gender, BMI, ASA-PS, tumor localization, and cStage as covariates.
Results:
231 patients in the ICG group and 231 patients in the non-ICG group were selected. The median operative time was 174 vs 175 minutes, which was not different (p = 0.737), and the median blood loss was 0 vs 5 ml, which was significantly smaller in the ICG group (p <0.001). The incidence of complications of Clavien-Dindo classification Grade 2 or higher was 8.2 vs 12.1% (p = 0.109), which was not different. The median number of lymph node dissections is 6 vs 4 (p <0.001) for the main lymph nodes, 7 vs 6 (p = 0.032) for the intermediate lymph nodes, and 31 vs 27 (p = 0.047) in total, which were significantly more in the ICG group. The 3-year recurrence-free survival by stage is Stage I: 100 vs 100%, Stage II: 87.4 vs 90.5% (p = 0.451), Stage III: 78.2 vs 73.5% (p = 0.709), and the 3-year overall survival is Stage I: 96.8 vs 100% (p = 0.091), Stage II: 92.3 vs 94.3% (p = 0.325), Stage III: 95.8 vs 87.6% (p = 0.364), and there was no significant difference between the two groups. The recurrence type (liver / lung / peritoneal dissemination / lymph node / local / other) was 7/6/2/1/2/1 vs 7/9/7/1/0/1, and there was no difference between the two groups.
Conclusion:
Although ICG-FI guided CME may be able to dissect the main and intermediate lymph nodes more precisely, there was no difference in mid-term results or recurrence type.
To investigate the oncologic outcomes of CME using intraoperative lymphatic flow evaluation by ICG fluorescence imaging (ICG-FI) in laparoscopic right hemicolectomy (LRHC) for right colon cancer.
Methods:
From January 2009 to December 2020, 921 patients who underwent D3 dissection for right-sided colon cancer except Stage IV were included. ICG-FI guided LRHC (ICG group) was performed in 233 cases, and LRHC without ICG-FI (non-ICG group) was performed in 688 cases. We compared and examined the oncologic outcomes after Propensity Score matching with age, gender, BMI, ASA-PS, tumor localization, and cStage as covariates.
Results:
231 patients in the ICG group and 231 patients in the non-ICG group were selected. The median operative time was 174 vs 175 minutes, which was not different (p = 0.737), and the median blood loss was 0 vs 5 ml, which was significantly smaller in the ICG group (p <0.001). The incidence of complications of Clavien-Dindo classification Grade 2 or higher was 8.2 vs 12.1% (p = 0.109), which was not different. The median number of lymph node dissections is 6 vs 4 (p <0.001) for the main lymph nodes, 7 vs 6 (p = 0.032) for the intermediate lymph nodes, and 31 vs 27 (p = 0.047) in total, which were significantly more in the ICG group. The 3-year recurrence-free survival by stage is Stage I: 100 vs 100%, Stage II: 87.4 vs 90.5% (p = 0.451), Stage III: 78.2 vs 73.5% (p = 0.709), and the 3-year overall survival is Stage I: 96.8 vs 100% (p = 0.091), Stage II: 92.3 vs 94.3% (p = 0.325), Stage III: 95.8 vs 87.6% (p = 0.364), and there was no significant difference between the two groups. The recurrence type (liver / lung / peritoneal dissemination / lymph node / local / other) was 7/6/2/1/2/1 vs 7/9/7/1/0/1, and there was no difference between the two groups.
Conclusion:
Although ICG-FI guided CME may be able to dissect the main and intermediate lymph nodes more precisely, there was no difference in mid-term results or recurrence type.
{{ help_message }}
{{filter}}