Effect analysis of indocyanine green fluorescence imaging technique in laparoscopic lateral lymph node dissection of rectal cancer

doi:10.3877/cma.j.issn.1674-3946.2025.01.013.

Abstract

Abstract:

Objective

To investigate the clinical effect of indocyanine green （ICG） fluorescence imaging in laparoscopic lateral lymph node dissection （LLND） for rectal cancer.

Methods

Data of 32 patients who underwent LLND surgery for middle and low rectal cancer from May 2020 to June 2023 were retrospectively analyzed.The patients were divided into conventional group （n=22 cases） and ICG group （n=10 cases） according to whether ICG fluorescence imaging was used during operation.SPSS 26.0 software was used for statistical analysis.All perioperative indicators were expressed as （x± s）， and independent sample t test was used between groups.The statistical data of postoperative complications were shown as［ cases （%）］ and χ² test was used.P＜0.05 was considered statistically significant.

Results

In the ICG group， the operative time was shortened［（6.8±0.9）h vs.（5.8±0.6）h， P=0.004］， and the amount of intraoperative blood loss was decreased［（266±149）ml vs.（155±86）ml， P=0.037］.Postoperative hospital stay was shortened［（10.6±2.4）d vs.（8.7±1.3）d，P=0.025］.There was no significant difference in postoperative complications between the two groups （P＞0.05）.The number of lateral lymph nodes detected in ICG group increased ［（4.4+3.1） vs.（6.9+2.5）， P=0.032］，but the positive lymph node detection rate did not increase （9.1% vs.30%， P=0.131）.

Conclusions

ICG fluorescence imaging assisted LLND can remove more lymph nodes without affecting the postoperative recovery of patients， which is clinically safe and feasible.

Key words: Rectal Tumor, Lateral Lymph Node Metastasis, Lymph Node Dissection, Indocyanine Green, Fluorescence Tracing

Shizhen Zhou, Xingya Zhu, Qinggang Yuan, Lixiang Liu, Kai Wang, Ji Miao, Chao Ding, Hao Wang, Wenxian Guan. Effect analysis of indocyanine green fluorescence imaging technique in laparoscopic lateral lymph node dissection of rectal cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 44-47.

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Figures/Tables 5

组别	例数	性别（例）（男/女）	年龄（岁， $\overset{ˉ}{x}$ ±s）	BMI（kg/m²， $\overset{ˉ}{x}$ ±s）	CRP（mg/L， $\overset{ˉ}{x}$ ±s）
常规组	22	17/5	59.2±7.0	23.0±2.3	3.5±3.0
ICG组	10	8/2	58.4±8.6	23.0±3.4	3.9±1.9
t/χ²值		0.030	0.271	0.004	0.370
P值		0.863	0.788	0.997	0.714
组别	例数	淋巴细胞（10⁹/L， $\overset{ˉ}{x}$ ±s）	中性粒细胞（10⁹/L， $\overset{ˉ}{x}$ ±s）	白蛋白（g/L， $\overset{ˉ}{x}$ ±s）	血红蛋白（g/L， $\overset{ˉ}{x}$ ±s）
常规组	22	1.5±0.8	3.4±1.3	40.3±2.4	130.5±20.6
ICG组	10	1.8±0.9	3.4±1.3	40.8±1.7	137.7±22.7
t/χ²值		1.273	0.062	0.514	0.852
P值		0.945	0.951	0.611	0.378

组别	例数	性别（例）（男/女）	年龄（岁， $\overset{ˉ}{x}$ ±s）	BMI（kg/m²， $\overset{ˉ}{x}$ ±s）	CRP（mg/L， $\overset{ˉ}{x}$ ±s）
常规组	22	17/5	59.2±7.0	23.0±2.3	3.5±3.0
ICG组	10	8/2	58.4±8.6	23.0±3.4	3.9±1.9
t/χ²值		0.030	0.271	0.004	0.370
P值		0.863	0.788	0.997	0.714
组别	例数	淋巴细胞（10⁹/L， $\overset{ˉ}{x}$ ±s）	中性粒细胞（10⁹/L， $\overset{ˉ}{x}$ ±s）	白蛋白（g/L， $\overset{ˉ}{x}$ ±s）	血红蛋白（g/L， $\overset{ˉ}{x}$ ±s）
常规组	22	1.5±0.8	3.4±1.3	40.3±2.4	130.5±20.6
ICG组	10	1.8±0.9	3.4±1.3	40.8±1.7	137.7±22.7
t/χ²值		1.273	0.062	0.514	0.852
P值		0.945	0.951	0.611	0.378

组别	例数	手术时间（h）	术中出血量（ml）	第一次通气时间（d）	第一次排便时间（d）	住院天数（d）
常规组	22	6.8±0.9	266±149	3.58±1.11	4.63±1.20	10.6±2.4
ICG组	10	6.0±0.6	155±86	2.83±2.19	3.41±2.07	8.7±1.3
t值		2.509	2.189	1.306	2.113	2.357
P值		0.004	0.037	0.201	0.043	0.025
组别	例数	CRP（mg/L）	淋巴细胞数量（10⁹/L）	中性粒细胞数量（10⁹/L）	白蛋白（g/L）	血红蛋白（g/L）
常规组	22	55.3±45.6	1.6±0.8	9.0±2.6	32.5±3.8	103.7±27.7
ICG组	10	40.4±16.4	1.4±0.7	7.7±.8	32.6±2.6	121.7±23.3
t值		1.001	0.798	1.414	0.104	1.787
P值		0.325	0.431	0.168	0.918	0.084

组别	例数	二次手术	切口感染	腹腔感染	吻合口漏
常规组	22	1	1	1	0
ICG组	10	0	1	0	1
χ²值		-	-	-	-
P值		-	-	-	-
组别	例数	尿潴留	性功能障碍	总发生率（%）
常规组	22	3	1	6（27.3）
ICG组	10	1	1	4（40.0）
χ²值		-	-	0.518
P值		-	-	0.472

组别	例数	总淋巴结清扫数（枚， $\overset{ˉ}{x}$ ±s）	阳性淋巴结检出率［例（%）］	侧方淋巴结清扫数（枚， $\overset{ˉ}{x}$ ±s）
常规组	22	20.6±8.3	12（54.5）	4.4±3.1
ICG组	10	26.9±6.1	5（50.0）	6.9±2.5
χ²/t值		2.132	0.057	2.244
P值		0.041	0.811	0.032
组别	例数	阳性侧方淋巴结检出率［例（%）］	253组淋巴结清扫数（枚， $\overset{ˉ}{x}$ ±s）	253组阳性淋巴结检出率［例（%）］
常规组	22	2（9.1）	2.6±2.5	3（13.6）
ICG组	10	3（30.0）	3.3±2.8	1（10.0）
χ²/t值		2.280	0.725	0.083
P值		0.131	0.474	0.773

组别	例数	总淋巴结清扫数（枚， $\overset{ˉ}{x}$ ±s）	阳性淋巴结检出率［例（%）］	侧方淋巴结清扫数（枚， $\overset{ˉ}{x}$ ±s）
常规组	22	20.6±8.3	12（54.5）	4.4±3.1
ICG组	10	26.9±6.1	5（50.0）	6.9±2.5
χ²/t值		2.132	0.057	2.244
P值		0.041	0.811	0.032
组别	例数	阳性侧方淋巴结检出率［例（%）］	253组淋巴结清扫数（枚， $\overset{ˉ}{x}$ ±s）	253组阳性淋巴结检出率［例（%）］
常规组	22	2（9.1）	2.6±2.5	3（13.6）
ICG组	10	3（30.0）	3.3±2.8	1（10.0）
χ²/t值		2.280	0.725	0.083
P值		0.131	0.474	0.773

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