Near-Infrared Imaging Using Indocyanine Green for Laparoscopic Lateral Pelvic Lymph Node Dissection for Clinical Stage II/III Middle-Lower Rectal Cancer: A Propensity Score-Matched Cohort Study
Near-Infrared Imaging Using Indocyanine Green for Laparoscopic Lateral Pelvic Lymph Node Dissection for Clinical Stage II/III Middle-Lower Rectal Cancer: A Propensity Score-Matched Cohort Study
复制标题
DOI：
10.1097/dcr.0000000000002156
复制
发表时间：
2022-07-01
影响因子：
3.9
通讯作者：
Endo, Itaru
中科院分区：
文献类型：
--
作者：
Ohya, Hiroki;Watanabe, Jun;Endo, Itaru
背景技术背景：在腹腔镜盆腔外侧淋巴结清扫术中使用吲哚菁绿色的近红外成像的有效性的检查仍然不足。目的：本研究的目的是检查近红外成像是否有助于在腹腔镜盆腔外侧淋巴结清扫术中收集的盆腔外侧淋巴结总数的增加。设计：这是一项回顾性的、多机构的研究，倾向评分匹配。设置：我们在日本横滨临床肿瘤学小组的框架内进行了这项研究。研究人群包括连续的中低位直肠癌患者（临床II至III期），于2013年1月至2018年2月期间接受腹腔镜盆腔外侧淋巴结清扫术。主要结果指标：在腹腔镜下盆腔外侧淋巴结清扫术中，比较了有无近红外成像的盆腔外侧淋巴结清扫术中收获的盆腔外侧淋巴结总数。结果：共纳入了172例符合条件的患者;其中84例患者接受了近红外成像的腹腔镜手术。倾向评分匹配后，近红外和非近红外组各匹配58例患者。近红外组手术时间明显长于非近红外组（426 vs 369 min），术中出血量明显少于非近红外组（13 vs 110 mL）。近红外组的盆腔外侧淋巴结总收获数显著高于非近红外组（14 vs 9）。有没有显着差异，术后并发症率的2 groups.LIMITATIONS：本研究的局限性，包括其回顾性design.CONCLUSIONS：这项研究表明，腹腔镜盆腔淋巴结清扫术结合近红外成像可以增加总数量收获盆腔淋巴结不损害功能的保护。
BACKGROUND: The examination of the efficacy of near-infrared imaging using indocyanine green in laparoscopic lateral pelvic lymph node dissection remains insufficient.OBJECTIVE: The aim of this study was to examine whether near-infrared imaging contributed to an increase in the total number of harvested lateral pelvic lymph nodes in laparoscopic lateral pelvic lymph node dissection.DESIGN: This was a retrospective, multi-institutional study with propensity score matching.SETTINGS: We conducted this study within the framework of the Yokohama Clinical Oncology Group in Japan.PATIENTS: The study population included consecutive patients with middle-low rectal cancer (clinical stage II to III) who underwent laparoscopic lateral pelvic lymph node dissection between January 2013 and February 2018.MAIN OUTCOME MEASURES: The total number of harvested lateral pelvic lymph nodes was compared in laparoscopic lateral pelvic lymph node dissection with and without near-infrared imaging.RESULTS: A total of 172 eligible patients were included; 84 of these patients underwent laparoscopic surgery with near-infrared imaging. After propensity score matching, 58 patients were matched in each of the near-infrared and the non-near-infrared groups. The operation time in the near-infrared group was significantly longer than that in the non-near-infrared group (426 vs 369 min), and the amount of intraoperative blood loss in the near-infrared group was significantly smaller than that in the non-near-infrared group (13 vs 110 mL). The total number of harvested lateral pelvic lymph nodes in the near-infrared group was significantly higher than that in the non-near-infrared group (14 vs 9). There were no significant differences in the postoperative complication rates of the 2 groups.LIMITATIONS: The limitations of the present study include its retrospective design.CONCLUSIONS: This study revealed that laparoscopic lateral pelvic lymph node dissection combined with near-infrared imaging could increase the total number of harvested lateral pelvic lymph nodes without impairing functional preservation.