Subserosal injection of indocyanine green fluorescence tracing technique in laparoscopic lymph node dissection for gastric cancer: a preliminary study

Introduction: Gastric cancer is a common malignancy of the digestive system, primarily metastasizing through lymph nodes.Adequate lymph node dissection is crucial for accurate staging and improving prognosis.However, the complex distribution of lymph nodes around the stomach poses significant challenges for thorough dissection.Aim: This study aims to evaluate the efficacy and safety of laparoscopic radical gastrectomy guided by subserosal injection of indocyanine green (ICG) fluorescence in lymph node dissection for gastric cancer.Materials and Methods: This retrospective study analyzed 20 patients who underwent distal gastrectomy at Wenzhou People's Hospital from January 2020 to December 2022.10 patients underwent conventional laparoscopic surgery, and 10 underwent laparoscopic surgery guided by ICG fluorescence.The two groups were propensity-matched based on gender, age, and preoperative staging.Data collected included basic patient information, lymph node dissection data, and perioperative outcomes (e.g., operative time, blood loss, and postoperative complications). Results:The results indicated that the total number of dissected lymph nodes was significantly higher in the fluorescence group compared to the conventional group, particularly in groups No. 6, 7, 8, 9, and 11p.The differences were statistically significant (P < 0.005).There were no significant differences between the two groups in terms of operative time, blood loss, and the incidence of postoperative complications (P > 0.05). Conclusion:This preliminary study demonstrates that using ICG fluorescence imaging in minimally invasive radical gastrectomy can significantly increase the number of lymph nodes dissected without increasing surgical risk.