Superior lymph node harvest by fluorescent lymphography during minimally invasive gastrectomy for gastric cancer patients with high body mass index

IF 6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastric Cancer Pub Date : 2024-03-19 DOI:10.1007/s10120-024-01482-w

Ki-Yoon Kim, Jawon Hwang, Sung Hyun Park, Minah Cho, Yoo Min Kim, Hyoung-Il Kim, Woo Jin Hyung

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引用次数: 0

Abstract

Background

Fluorescent lymphography (FL) using indocyanine green (ICG) allows for the visualization of all draining lymph nodes (LNs), thereby increasing LN retrieval. However, no studies have assessed the efficacy of FL in high body mass index (BMI) gastric cancer patients, even as LN yield decreases with increasing BMI in gastrectomy. This study aimed to investigate the influence of FL on LN retrieval in high BMI gastric cancer patients.

Methods

Gastric cancer patients who underwent laparoscopic or robotic gastrectomies from 2013 to 2021 were included. Patients were classified into two groups, with FL (FL group) or without FL (non-FL group). The effect of FL on LN retrieval was assessed by BMI. Inverse probability of treatment weighting (IPTW) was used to ensure comparability between groups.

Results

Retrieved LN number decreased as BMI increased regardless of FL application (P < 0.001). According to the IPTW analysis, the mean retrieved LN number was significantly higher in the FL group (48.4 ± 18.5) than in the non-FL group (39.8 ± 16.3, P < 0.001), irrespective of BMI. The FL group exhibited a significantly higher proportion of patients with 16 or more LNs (99.5%) than the non-FL group (98.1%, P < 0.001). The FL group also had a significantly higher proportion of patients with 30 or more LNs (86.6%) than the non-FL group (72.2%, P < 0.001). In both the normal and high-BMI patients, the FL group had a significantly larger percentage of patients with a higher nodal classification than the non-FL group.

Conclusion

FL resulted in more LN retrieval, even in high BMI patients. FL ensures accurate staging by maintaining the appropriate retrieved LN number in high BMI gastric cancer patients.

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在对体重指数较高的胃癌患者进行微创胃切除术时，通过荧光淋巴造影术采集优质淋巴结

背景使用吲哚菁绿（ICG）进行荧光淋巴造影（FL）可显示所有引流淋巴结（LN），从而提高 LN 检出率。然而，还没有研究评估过荧光淋巴造影对高体重指数（BMI）胃癌患者的疗效，即使在胃切除术中随着体重指数（BMI）的增加，淋巴结检出率也会降低。本研究旨在探讨FL对高体重指数胃癌患者LN取材率的影响。方法纳入2013年至2021年期间接受腹腔镜或机器人胃切除术的胃癌患者。患者被分为两组，有FL（FL组）和无FL（非FL组）。通过BMI评估FL对LN取材的影响。结果无论是否应用 FL，随着 BMI 的增加，检索到的 LN 数量减少（P <0.001）。根据 IPTW 分析，FL 组（48.4 ± 18.5）明显高于非 FL 组（39.8 ± 16.3，P < 0.001），与 BMI 无关。FL 组患者中有 16 个或更多 LN 的比例（99.5%）明显高于非 FL 组（98.1%，P < 0.001）。FL 组患者中 LNs 达到或超过 30 个的比例（86.6%）也明显高于非 FL 组（72.2%，P < 0.001）。在正常和高 BMI 患者中，FL 组结节分类较高的患者比例明显高于非FL 组。FL通过保持高BMI胃癌患者适当的LN检索数目，确保了准确的分期。

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

Gastric Cancer 医学-胃肠肝病学

CiteScore

14.70

自引率

2.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.