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Revista argentina de cirugía
Print version ISSN 2250-639XOn-line version ISSN 2250-639X
Abstract
SCHLOTTMANN, Francisco and BUXHOEVEDEN, Rudolf. Esophagectomy with lymphadenectomy guided by fluorescence imaging with indocyanine green in esophageal cancer. Initial experience in Argentina. Rev. argent. cir. [online]. 2022, vol.114, n.1, pp.20-25. ISSN 2250-639X. http://dx.doi.org/10.25132/raac.v114.n1.1652.
Background:
Over the past decade, fluorescence imaging with infrared light has been used to visualize lymph nodes in tumors of the stomach and esophagus.
Objective:
The aim of our study was to evaluate the feasibility of evaluating lymphatic drainage in esophageal cancer using fluorescence and indocyanine green (ICG).
Material and methods:
We conducted a prospective study of patients with resectable tumors of the gastroesophageal junction (stage I, II and III). Before surgery, 4 mL of ICG double diluted in sterile water (1.25 mg/mL = 5 mg) were injected via endoscopy into the esophageal submucosa in the four quadrants (1 mL per quadrant) around the tumor.
Results:
A total of 6 patients were included. Lymphatic drainage from the tumor to the first lymph node station was identified in all patients: in 6/6 (100%), fluorescent lymphatic drainage was detected in nodal stations number 3 and 7 (lesser curvature and left gastric artery) Fluorescence was not identified in the mediastinal lymph nodes in any patient.
Conclusion:
Visualization of lymphatic drainage of gastroesophageal junction tumors to the lesser curvature nodes using fluorescence imaging is feasible.
Keywords : Esophageal cancer; Lymphatic drainage; Fluorescence; ICG.