Wenlong Qiu, Cheng Zhou, Wei Zhao, Shiwen Mei, Qian Liu
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Postoperative complications, recurrence rates, and survival outcomes were assessed. Statistical analysis was performed using χ<sup>2</sup> tests, Mann-Whitney U tests, Kaplan-Meier survival curves, and Cox proportional hazards models. FL-SLNB (173 patients) showed better perioperative outcomes than non-SLNB (128 patients), with shorter hospital stays (7 vs. 10 days, P = 0.027), less blood loss (150 vs. 180 mL, P = 0.032), and fewer complications: intraoperative bleeding (2.9% vs. 6.3%, P = 0.041), anastomotic leakage (1.7% vs. 3.9%, P = 0.045), and urinary dysfunction (3.5% vs. 7.0%, P = 0.039). No significant differences were observed in survival or recurrence rates (P > 0.05). pN stage was a significant predictor of distant metastasis (HR 1.953, P = 0.037). ICG-guided SLNB enhanced surgical precision and reduced unnecessary LLND in lower LARC with clinically negative LLNs, and improved surgical decision-making and minimizes postoperative complications.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"ICG fluorescence-guided sentinel lymph node biopsy for decision-making in lateral lymph node dissection in local advanced rectal cancer: a retrospective study.\",\"authors\":\"Wenlong Qiu, Cheng Zhou, Wei Zhao, Shiwen Mei, Qian Liu\",\"doi\":\"10.1007/s13304-025-02169-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Local advanced rectal cancer (LARC) carries high recurrence risks, especially with lateral lymph node (LLN) involvement. This study aims to evaluate the role of ICG-guided sentinel lymph node biopsy (SLNB) in patients with clinical negative LLNs (maximum diameter < 7 mm), potentially reducing unnecessary surgeries and associated complications in patients with LARC. A retrospective analysis of 301 consecutive patients with lower LARC who underwent fluorescent lateral pelvic sentinel lymph node biopsy (FL-SLNB) or conventional LLND at the Cancer Hospital, Chinese Academy of Medical Sciences between 2018 and 2022 was conducted. Clinical and pathological data were collected, and the patients were grouped into FL-SLNB and non-SLNB groups. Postoperative complications, recurrence rates, and survival outcomes were assessed. Statistical analysis was performed using χ<sup>2</sup> tests, Mann-Whitney U tests, Kaplan-Meier survival curves, and Cox proportional hazards models. FL-SLNB (173 patients) showed better perioperative outcomes than non-SLNB (128 patients), with shorter hospital stays (7 vs. 10 days, P = 0.027), less blood loss (150 vs. 180 mL, P = 0.032), and fewer complications: intraoperative bleeding (2.9% vs. 6.3%, P = 0.041), anastomotic leakage (1.7% vs. 3.9%, P = 0.045), and urinary dysfunction (3.5% vs. 7.0%, P = 0.039). No significant differences were observed in survival or recurrence rates (P > 0.05). pN stage was a significant predictor of distant metastasis (HR 1.953, P = 0.037). ICG-guided SLNB enhanced surgical precision and reduced unnecessary LLND in lower LARC with clinically negative LLNs, and improved surgical decision-making and minimizes postoperative complications.</p>\",\"PeriodicalId\":23391,\"journal\":{\"name\":\"Updates in Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-04-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Updates in Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s13304-025-02169-2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Updates in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13304-025-02169-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
局部晚期直肠癌(LARC)具有很高的复发风险,特别是与外侧淋巴结(LLN)累及。本研究旨在评估icg引导前哨淋巴结活检(SLNB)在临床阴性LLNs患者中的作用(最大直径2试验、Mann-Whitney U试验、Kaplan-Meier生存曲线和Cox比例风险模型)。FL-SLNB(173例)围手术期预后优于非slnb(128例),住院时间短(7天vs 10天,P = 0.027),出血量少(150 mL vs 180 mL, P = 0.032),并发症少:术中出血(2.9% vs. 6.3%, P = 0.041),吻合口漏(1.7% vs. 3.9%, P = 0.045),尿功能障碍(3.5% vs. 7.0%, P = 0.039)。两组生存率、复发率差异无统计学意义(P < 0.05)。pN分期是远处转移的重要预测因子(HR 1.953, P = 0.037)。icg引导下的SLNB提高了手术精度,减少了临床阴性lln的下LARC的不必要LLND,改善了手术决策,最大限度地减少了术后并发症。
ICG fluorescence-guided sentinel lymph node biopsy for decision-making in lateral lymph node dissection in local advanced rectal cancer: a retrospective study.
Local advanced rectal cancer (LARC) carries high recurrence risks, especially with lateral lymph node (LLN) involvement. This study aims to evaluate the role of ICG-guided sentinel lymph node biopsy (SLNB) in patients with clinical negative LLNs (maximum diameter < 7 mm), potentially reducing unnecessary surgeries and associated complications in patients with LARC. A retrospective analysis of 301 consecutive patients with lower LARC who underwent fluorescent lateral pelvic sentinel lymph node biopsy (FL-SLNB) or conventional LLND at the Cancer Hospital, Chinese Academy of Medical Sciences between 2018 and 2022 was conducted. Clinical and pathological data were collected, and the patients were grouped into FL-SLNB and non-SLNB groups. Postoperative complications, recurrence rates, and survival outcomes were assessed. Statistical analysis was performed using χ2 tests, Mann-Whitney U tests, Kaplan-Meier survival curves, and Cox proportional hazards models. FL-SLNB (173 patients) showed better perioperative outcomes than non-SLNB (128 patients), with shorter hospital stays (7 vs. 10 days, P = 0.027), less blood loss (150 vs. 180 mL, P = 0.032), and fewer complications: intraoperative bleeding (2.9% vs. 6.3%, P = 0.041), anastomotic leakage (1.7% vs. 3.9%, P = 0.045), and urinary dysfunction (3.5% vs. 7.0%, P = 0.039). No significant differences were observed in survival or recurrence rates (P > 0.05). pN stage was a significant predictor of distant metastasis (HR 1.953, P = 0.037). ICG-guided SLNB enhanced surgical precision and reduced unnecessary LLND in lower LARC with clinically negative LLNs, and improved surgical decision-making and minimizes postoperative complications.
期刊介绍:
Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future.
Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts.
Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.