Safety and efficacy of indocyanine green near-infrared fluorescent imaging-guided lymph nodes dissection during radical gastrectomy for gastric cancer: A systematic review and meta-analysis
BackgroundIndocyanine green (ICG) fluorescence imaging has been a new surgical navigation technique for gastric cancer. However, its clinical value should still be evaluated further. In this meta-analysis, we investigated the safety and efficacy of ICG near-infrared fluorescent imaging-guided lymph...
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| Format: | Article |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.917541/full |
| _version_ | 1798039851991302144 |
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| author | Chun Deng Zhenyu Zhang Hengduo Qi Zhi Guo Yang Liu Haimin Xiao Xiaojun Li |
| author_facet | Chun Deng Zhenyu Zhang Hengduo Qi Zhi Guo Yang Liu Haimin Xiao Xiaojun Li |
| author_sort | Chun Deng |
| collection | DOAJ |
| description | BackgroundIndocyanine green (ICG) fluorescence imaging has been a new surgical navigation technique for gastric cancer. However, its clinical value should still be evaluated further. In this meta-analysis, we investigated the safety and efficacy of ICG near-infrared fluorescent imaging-guided lymph nodes (LNs) dissection during radical gastrectomy.MethodsStudies comparing ICG fluorescence imaging with standard care in patients with gastric cancer were systematically searched from PubMed, Embase, Web of Science, and Cochrane Library through August 2021. 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 LNs dissection, the number of metastatic LNs dissection, other operative outcomes, and postoperative complications. R software version 4.2.0 and Stata 16.0 software were used for the present meta-analysis.ResultsThis analysis included 12 studies with a total of 1365 gastric cancer patients (569 in the ICG group and 796 in the non-ICG group). The number of retrieved LNs in the ICG group was significantly higher (weighted mean difference [WMD]=7.67, 95% confidence intervals [CI]: 4.73 to 10.62, P<0.05) compared to the non-ICG group with moderate heterogeneity (P<0.001, I2 = 70%). The number of metastatic LNs, operative time, and postoperative complications were all comparable and without significant heterogeneity. Additionally, ICG near-infrared fluorescent imaging was associated with reduced intraoperative blood loss (WMD=-10.28, 95% CI: -15.22 to -5.35, P<0.05) with low heterogeneity (P=0.07, I2 = 43%).ConclusionsICG near-infrared fluorescent imaging-guided lymphadenectomy was considered to be safe and effective in gastrectomy. ICG was used to increase the number of LNs harvested while reducing intraoperative blood loss without increasing operative time or postoperative complications.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021291863. |
| first_indexed | 2024-04-11T21:59:24Z |
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| id | doaj.art-4af1d4d219d34f4ba120b4981f9ffa3b |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-11T21:59:24Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj.art-4af1d4d219d34f4ba120b4981f9ffa3b2022-12-22T04:01:00ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-08-011210.3389/fonc.2022.917541917541Safety and efficacy of indocyanine green near-infrared fluorescent imaging-guided lymph nodes dissection during radical gastrectomy for gastric cancer: A systematic review and meta-analysisChun Deng0Zhenyu Zhang1Hengduo Qi2Zhi Guo3Yang Liu4Haimin Xiao5Xiaojun Li6Department of Gastrointestinal Surgery, the Second People’s Hospital of Yibin, Yibin City, ChinaDepartment of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an City, ChinaDepartment of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an City, ChinaDepartment of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an City, ChinaDepartment of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an City, ChinaDepartment of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an City, ChinaDepartment of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an City, ChinaBackgroundIndocyanine green (ICG) fluorescence imaging has been a new surgical navigation technique for gastric cancer. However, its clinical value should still be evaluated further. In this meta-analysis, we investigated the safety and efficacy of ICG near-infrared fluorescent imaging-guided lymph nodes (LNs) dissection during radical gastrectomy.MethodsStudies comparing ICG fluorescence imaging with standard care in patients with gastric cancer were systematically searched from PubMed, Embase, Web of Science, and Cochrane Library through August 2021. 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 LNs dissection, the number of metastatic LNs dissection, other operative outcomes, and postoperative complications. R software version 4.2.0 and Stata 16.0 software were used for the present meta-analysis.ResultsThis analysis included 12 studies with a total of 1365 gastric cancer patients (569 in the ICG group and 796 in the non-ICG group). The number of retrieved LNs in the ICG group was significantly higher (weighted mean difference [WMD]=7.67, 95% confidence intervals [CI]: 4.73 to 10.62, P<0.05) compared to the non-ICG group with moderate heterogeneity (P<0.001, I2 = 70%). The number of metastatic LNs, operative time, and postoperative complications were all comparable and without significant heterogeneity. Additionally, ICG near-infrared fluorescent imaging was associated with reduced intraoperative blood loss (WMD=-10.28, 95% CI: -15.22 to -5.35, P<0.05) with low heterogeneity (P=0.07, I2 = 43%).ConclusionsICG near-infrared fluorescent imaging-guided lymphadenectomy was considered to be safe and effective in gastrectomy. ICG was used to increase the number of LNs harvested while reducing intraoperative blood loss without increasing operative time or postoperative complications.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021291863.https://www.frontiersin.org/articles/10.3389/fonc.2022.917541/fullindocyanine greenlaparoscopic surgerylymph nodegastric cancerrobotic gastrectomymeta-analysis |
| spellingShingle | Chun Deng Zhenyu Zhang Hengduo Qi Zhi Guo Yang Liu Haimin Xiao Xiaojun Li Safety and efficacy of indocyanine green near-infrared fluorescent imaging-guided lymph nodes dissection during radical gastrectomy for gastric cancer: A systematic review and meta-analysis Frontiers in Oncology indocyanine green laparoscopic surgery lymph node gastric cancer robotic gastrectomy meta-analysis |
| title | Safety and efficacy of indocyanine green near-infrared fluorescent imaging-guided lymph nodes dissection during radical gastrectomy for gastric cancer: A systematic review and meta-analysis |
| title_full | Safety and efficacy of indocyanine green near-infrared fluorescent imaging-guided lymph nodes dissection during radical gastrectomy for gastric cancer: A systematic review and meta-analysis |
| title_fullStr | Safety and efficacy of indocyanine green near-infrared fluorescent imaging-guided lymph nodes dissection during radical gastrectomy for gastric cancer: A systematic review and meta-analysis |
| title_full_unstemmed | Safety and efficacy of indocyanine green near-infrared fluorescent imaging-guided lymph nodes dissection during radical gastrectomy for gastric cancer: A systematic review and meta-analysis |
| title_short | Safety and efficacy of indocyanine green near-infrared fluorescent imaging-guided lymph nodes dissection during radical gastrectomy for gastric cancer: A systematic review and meta-analysis |
| title_sort | safety and efficacy of indocyanine green near infrared fluorescent imaging guided lymph nodes dissection during radical gastrectomy for gastric cancer a systematic review and meta analysis |
| topic | indocyanine green laparoscopic surgery lymph node gastric cancer robotic gastrectomy meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.917541/full |
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