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Study finds that while indocyanine green (ICG) fluorescence imaging may enhance the identification of lymph nodes during laparoscopic right-sided colectomy, there was no significant difference in 3-year relapse-free survival and overall survival compared to non-ICG-guided procedures.
The following is a summary of “Short-term and Mid-term Outcomes of Indocyanine Green Fluorescence Imaging–Guided Laparoscopic Right-Sided Colectomy: A Propensity Score–Matched Cohort Study,” published in the January 2024 issue of Gastroenterology by Daibo, et al.
With indocyanine green (ICG) fluorescence imaging, it is possible to check the flow of lymphatic fluid during surgery. However, there is no report on how the ICG fluorescence imaging–guided laparoscopic right-sided colectomy turned out in the middle of the treatment period. For a study, researchers sought to look at how the ICG fluorescence imaging–guided laparoscopic right-sided colectomy went in the middle of the treatment period. This historical study used propensity score matching and looked at data from more than one school.
The study included 921 people who had a laparoscopic right-sided colectomy with lymph node dissection for colon cancer in stages I to III between January 2009 and December 2020. The patients were split into two groups: the ICG group had 233 patients who had lymphatic flow evaluations and the non–ICG green group had 688 patients who did not have lymphatic flow evaluations.
The 3-year mortality rate without recurrence after a laparoscopic right-sided colectomy with and without ICG fluorescence imaging was looked at. After matching based on likelihood scores, 231 patients were put into each group. The ICG group had a lot more damaged central lymph nodes (6 vs. 4, P < 0.001), damaged middle lymph nodes (7 vs. 6, P= 0.03), and damaged lymph nodes overall (31 vs. 27, P = 0.047). It took 36.9 months on average to follow up. The ICG group had 88.8% relapse-free survival and 94.5% overall survival after 3 years, while the non–ICG group had 89.4% relapse-free survival and 94.7% overall survival (P= 0.721 and 0.300, respectively). There was no difference between the two groups.
The results showed that using ICG fluorescence imaging to guide a laparoscopic right-sided colectomy may help increase the number of total, intermediate, and central lymph nodes. But there was no difference between the 2 groups.