Safety and efficacy of indocyanine green near-infrared fluorescent imaging-guided lymph node dissection during robotic gastrectomy for gastric cancer: a systematic review and meta-analysis.

IF 1.7 4区医学 Q2 SURGERY

Minimally Invasive Therapy & Allied Technologies Pub Date : 2023-10-01 Epub Date: 2023-01-13 DOI:10.1080/13645706.2023.2165415

Zhenyu Zhang, Chun Deng, Zhi Guo, Yang Liu, Hengduo Qi, Xiaojun Li

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引用次数: 2

Abstract

Background: In Asia, particularly, robotic gastrectomy has grown in popularity as a treatment for stomach cancer. Indocyanine green (ICG) and near-infrared (NIR) fluorescent imaging technology has been reported for robotic gastrectomy. However, the clinical value still should be further evaluated. In this meta-analysis, we investigated the safety and efficacy of ICG near-infrared fluorescent imaging-guided lymph node (LN) dissection during robotic gastrectomy.

Material and methods: Through July 2022, systematic searches of PubMed, Embase, Web of Science, and the Cochrane Library were conducted to find studies comparing ICG fluorescence imaging with conventional treatment in patients with gastric cancer. The current meta-analysis was performed according to the preferred reporting items for systematic review and meta-analysis guidelines. A pooled analysis was performed for the available data regarding the number of lymph node dissections, other operative outcomes and postoperative complications. R studio software 4.2.2 was used for this meta-analysis.

Results: This analysis includes five studies with a total of 312 gastric cancer patients (128 in the ICG group and 184 in the non-ICG group). In this meta-analysis, the number of retrieved LNs in the ICG group was significantly higher (weighted mean difference [WMD] = 8.80, 95% confidence intervals [CI]: 4.37-13.22, p < 0.05) than that in the non-ICG group with moderate heterogeneity (p < 0.0001, I²=53.3%). Intraoperative blood loss and postoperative complications were all comparable and without significant heterogeneity. Additionally, ICG near-infrared fluorescent imaging was associated with a reduced operative time (WMD= -11.85, 95% CI: -22.40 to -1.30, p < 0.05) with low heterogeneity (p = 0.027, I²= 2.1%).

Conclusions: ICG near-infrared fluorescent imaging-guided lymphadenectomy was considered to be safe and effective in robotic gastrectomy. ICG was used to increase the number of LNs harvested while reducing operative time without increasing intraoperative blood loss or postoperative complications.

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机器人胃癌切除术中吲哚菁绿近红外荧光成像引导淋巴结清扫的安全性和有效性:一项系统综述和荟萃分析。

背景：特别是在亚洲，机器人胃切除术作为癌症的一种治疗方法越来越受欢迎。吲哚菁绿（ICG）和近红外（NIR）荧光成像技术已被报道用于机器人胃切除术。然而，其临床价值仍有待进一步评估。在这项荟萃分析中，我们研究了ICG近红外荧光成像引导的淋巴结（LN）清扫在机器人胃切除术中的安全性和有效性。材料和方法：截至2022年7月，对PubMed、Embase、Web of Science和Cochrane图书馆进行了系统搜索，以寻找比较癌症患者ICG荧光成像与常规治疗的研究。目前的荟萃分析是根据系统综述和荟萃分析指南的首选报告项目进行的。对淋巴结解剖次数、其他手术结果和术后并发症的可用数据进行汇总分析。结果：该分析包括5项研究，共312名癌症患者（ICG组128名，非ICG组184名）。在这项荟萃分析中，ICG组中回收的LNs数量显著更高（加权平均差[MWMD] = 8.80，95%置信区间[CI]:4.37-13.22，p p 2＝53.3%）。术中出血和术后并发症均具有可比性，且无显著异质性。此外，ICG近红外荧光成像与手术时间缩短有关（WMD= -11.85，95%可信区间：-22.40至-1.30，p p = 0.027，I2=2.1%）。结论：ICG近红外荧光成像引导的淋巴结清扫术在机器人胃切除术中被认为是安全有效的。ICG用于增加采集的LNs数量，同时减少手术时间，而不增加术中失血或术后并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minimally Invasive Therapy & Allied Technologies 医学-外科

CiteScore

3.80

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.