ArticleTechniques in coloproctology2025
Fluorescence lymph node mapping using ICG improves lateral lymph node dissection for mid-low rectal cancer: a propensity score-matched cohort.
Article in Techniques in coloproctology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Indocyanine green-guided robotic-assisted mesorectal lymphadenectomy for high-risk T1 rectal carcinoma: Preliminary results of a prospective cohort study (IDEAL stage 2a).Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Observational
- Article
- Multidisciplinary prospective study of standardized pelvic lymph-node dissection focusing on the dorsal obturator nerve region.International journal of clinical oncology · 2026Observational
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11 authors.
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Abstract
backgroundPatients with lateral lymph node metastasis (LLNM) present particular challenges for both diagnosis and treatment. This study aimed to assess whether indocyanine green (ICG)-assisted lymph node mapping with near-infrared imaging (NIRI) enhances the effectiveness of lateral lymph node dissection (LLND) by further categorizing the lateral lymph nodes in patients with mid-low rectal cancer.
methodsSubmucosal indocyanine green injection was performed on the distal margin of the rectal cancer. In the ICG-LLND group, the lymphatic drainage pathway and distribution of lateral lymph nodes (LLNs) were explored using a laparoscopic NIRI system. Pathological evaluations were conducted for both the ICG-LLND group and the control group.
resultsThe ICG-LLND group demonstrated a significantly shorter postoperative hospital stay compared to the control group, both before (P < 0.001) and after (P = 0.001) matching. While blood loss and operating time were similar between groups, the ICG-LLND group had fewer cases of anastomotic leakage (P = 0.206). Postoperative lymph node harvesting was significantly higher in the ICG-LLND group, with more total lymph nodes (P = 0.001) and lateral lymph nodes (P = 0.002) harvested. The number of harvested lymph nodes in the obturator and internal iliac regions was also higher in the ICG-LLND group (P = 0.001), and the number of positive lymph nodes in these regions was significantly greater before (P = 0.027) and after (P = 0.013) matching. Univariate and multivariate analyses showed that ICG-LLND, nCRT, and positive pN stage were associated with increased lymph node harvest.
conclusionsICG-LLND improved lateral lymph node harvest, particularly obturator lymph nodes, and shortened postoperative hospital stay without increasing complications. This technique may enhance surgical outcomes in patients requiring lymph node dissection.
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