KEY TAKEAWAYS
- The study aimed to investigate the safety and feasibility of ICG-NIR fluorescence-guided VEIL for patients with rectal cancer with ILNM.
- Researchers concluded that ICG-NIR VEIL is a safe, feasible, and precise approach.
Y Sun and the team aimed to investigate the safety and feasibility of indocyanine green near-infrared fluorescence (ICG-NIR) fluorescence-guided video-endoscopic inguinal lymphadenectomy (VEIL) for rectal cancer with inguinal lymph node metastasis (ILNM).
Researchers performed an inclusive analysis on 11 patients with rectal cancer who underwent ICG-NIR fluorescence-guided VEIL. The study assessed various parameters including operation time, intraoperative bleeding, number of harvested lymph nodes, intraoperative and postoperative complications, and follow-up outcomes.
About surgical procedures for ILNM, unilateral surgery was performed in 7 cases (54.5%) and bilateral surgery in 4 cases (45.5%). Among these 15 ICG-NIR-guided VEIL surgeries in 11 patients, positive fluorescence visualization was achieved in 13 operations (86.7%). The median estimated blood loss was 10 ml, and the median operation time was 90 min. One case (6.7%) required conversion to open surgery.
The median duration of the drain tube was 12 days, and the median length of postoperative hospital stay was 20 days. Postoperative complications were observed, including incisional infection in 2 cases (18.2%), lymphatic leakage in 5 cases (45.5%), urinary infection in 1 case (9.1%), and pneumonia in 3 cases (27.3%). Complications such as skin necrosis, lower limb venous thrombosis, lower limb swelling, or impaired movement were observed during the postoperative follow-up period. No cases of primary lesion, groin, or pelvic lymph node recurrence were observed.
The study concluded that ICG-NIR fluorescence-guided VEIL emerges as a safe and feasible surgical option for rectal cancer with ILNM. The use of ICG fluorescence holds promise for enhancing the precision and personalization of VEIL in rectal cancer surgery.
This study was funded by the Construction Project of Fujian Province Minimally Invasive Medical Center, Young and Middle-aged Backbone Training Project in the Health System of Fujian Province, Natural Science Foundation of Fujian Province, and Medical Science Research Foundation of Beijing Medical and Health Foundation, Fujian provincial health technology project, and Bethune Charitable Foundation.
Source: https://pubmed.ncbi.nlm.nih.gov/38844577/
Sun Y, Tang Z, Xu Z, et al. (2024). “Indocyanine green near-infrared fluorescence-assisted video endoscopic inguinal lymph node dissection for rectal cancer: a single-center experience.” Tech Coloproctol. 2024 Jun 6;28(1):64. doi: 10.1007/s10151-024-02937-z. PMID: 38844577.
