Abdullah Afridi, Maria Qadri, Fatima Sajjad, Hira Habib, Iqra Khan, Iqra Shahid, Yasir Saleem, Fazia Khattak, Farwa Nisa, Hanifullah Khan, Zaryab Bacha, Muhammad Abdullah Ali, Hafsa Khan, Muhammad Hamza Khan, Rizwan Afridi, Kamil Ahmad Kamil
{"title":"Comparing ICG-Guided vs. Conventional Laparoscopic Lymphadenectomy in Gastric Cancer: A Systematic Review and Meta-Analysis.","authors":"Abdullah Afridi, Maria Qadri, Fatima Sajjad, Hira Habib, Iqra Khan, Iqra Shahid, Yasir Saleem, Fazia Khattak, Farwa Nisa, Hanifullah Khan, Zaryab Bacha, Muhammad Abdullah Ali, Hafsa Khan, Muhammad Hamza Khan, Rizwan Afridi, Kamil Ahmad Kamil","doi":"10.1007/s12029-025-01327-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer remains one of the leading causes of cancer-related mortality worldwide, with surgical intervention being a critical aspect of treatment. Lymphadenectomy plays a significant role in managing gastric cancer, with the extent of lymph node removal often influencing survival outcomes. Recent advancements in laparoscopic surgery have introduced the use of indocyanine green (ICG) fluorescence guidance to improve the accuracy and effectiveness of lymphadenectomy. However, the comparative efficacy of ICG-guided laparoscopic lymphadenectomy versus conventional techniques remains a topic of ongoing investigation.</p><p><strong>Aim: </strong>This study aims to evaluate the effectiveness and surgical outcomes of ICG-guided laparoscopic lymphadenectomy compared to conventional laparoscopic lymphadenectomy in patients with gastric cancer.</p><p><strong>Methods: </strong>A systematic review and meta-analysis, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements, was conducted (PROSPERO: CRD420251039604). A literature review was performed (sources: PubMed, Embase, and Cochrane Library databases; end-of-search date: April 22, 2025) and quality assessment was performed using the ROB 2 and Newcastle-Ottawa Scale. A random-effects model was used to pool the data for the meta-analyses.</p><p><strong>Results: </strong>A total of 3996 patients from ten studies were analyzed, with 1870 undergoing ICG-guided surgery and 2126 in the non-ICG group. ICG use was associated with significantly improved 1-year (RR = 1.04) and 2-year (RR = 1.09) overall survival, and a greater number of retrieved lymph nodes (MD = 6.00). While intraoperative blood loss was significantly reduced with ICG (MD = - 14.44 mL), no significant differences were observed in metastatic lymph node count, postoperative complications, operative time, or hospital stay.</p><p><strong>Conclusions: </strong>ICG-guided surgery in gastric cancer is associated with improved short- and mid-term overall survival and enhanced lymph node retrieval. It also significantly reduces intraoperative blood loss without increasing postoperative complications, operative time, or hospital stay. These findings support the clinical value of ICG in improving surgical outcomes.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"202"},"PeriodicalIF":1.6000,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastrointestinal Cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12029-025-01327-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Gastric cancer remains one of the leading causes of cancer-related mortality worldwide, with surgical intervention being a critical aspect of treatment. Lymphadenectomy plays a significant role in managing gastric cancer, with the extent of lymph node removal often influencing survival outcomes. Recent advancements in laparoscopic surgery have introduced the use of indocyanine green (ICG) fluorescence guidance to improve the accuracy and effectiveness of lymphadenectomy. However, the comparative efficacy of ICG-guided laparoscopic lymphadenectomy versus conventional techniques remains a topic of ongoing investigation.
Aim: This study aims to evaluate the effectiveness and surgical outcomes of ICG-guided laparoscopic lymphadenectomy compared to conventional laparoscopic lymphadenectomy in patients with gastric cancer.
Methods: A systematic review and meta-analysis, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements, was conducted (PROSPERO: CRD420251039604). A literature review was performed (sources: PubMed, Embase, and Cochrane Library databases; end-of-search date: April 22, 2025) and quality assessment was performed using the ROB 2 and Newcastle-Ottawa Scale. A random-effects model was used to pool the data for the meta-analyses.
Results: A total of 3996 patients from ten studies were analyzed, with 1870 undergoing ICG-guided surgery and 2126 in the non-ICG group. ICG use was associated with significantly improved 1-year (RR = 1.04) and 2-year (RR = 1.09) overall survival, and a greater number of retrieved lymph nodes (MD = 6.00). While intraoperative blood loss was significantly reduced with ICG (MD = - 14.44 mL), no significant differences were observed in metastatic lymph node count, postoperative complications, operative time, or hospital stay.
Conclusions: ICG-guided surgery in gastric cancer is associated with improved short- and mid-term overall survival and enhanced lymph node retrieval. It also significantly reduces intraoperative blood loss without increasing postoperative complications, operative time, or hospital stay. These findings support the clinical value of ICG in improving surgical outcomes.
期刊介绍：
The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
