Safety and efficacy of carbon nanoparticle suspension injection and indocyanine green tracer-guided lymph node dissection during robotic distal gastrectomy in patients with gastric cancer

Xuefeng Zhao,Dong Wang,Qun Zhao,Yiyang Hu,Yuan Tian,Liqiao Fan,Yecheng Lin,Bibo Tan,Yong Li,Honghai Guo

doi:10.1007/s00464-021-08630-8

Xuefeng Zhao, Dong Wang + Show 8 more

Open Access

https://doi.org/10.1007/s00464-021-08630-8

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Abstract

BackgroundThere is a lack of comparative analyses on the use of carbon nanoparticle suspension injection (CNSI) and indocyanine green (ICG) tracer technology for lymph node detection and their perioperative safety in robotic radical gastrectomy.MethodsA retrospective analysis was performed on patients who underwent robotic distal gastrectomy between November 2019 and November 2020. Patients were assigned to the CNSI group, the ICG group, or the control group. The number of lymph nodes detected, number of lymph nodes detected at each station, number of micro lymph nodes detected, rate of lymph node metastasis, and inoperative and postoperative recovery were compared.ResultsOf the 93 patients analyzed, 34 were in the CNSI group, 27 were in the ICG group, and 32 were in the control group. The mean number of lymph nodes retrieved in the CNSI group (48.44) was higher than that in the ICG (39.19) and control (35.28) groups (P = 0.004; P < 0.001), and there was no difference between the ICG and control groups (P = 0.102). The mean number of micro lymph nodes retrieved in the CNSI group (13.24) was higher than that in the ICG (5.74) and control (5.66) groups (P < 0.001). The lymph node metastasis rates in the CNSI, ICG, and control groups were 5.03, 4.63, and 5.93%, respectively (P > 0.05).ConclusionThe effect of CNSI on lymph node dissection and sorting was better than that of ICG, and CNSI improved the surgical quality and reduced lymph node staging deviation to a greater extent. CNSI was better than ICG in terms of improving the number of micro lymph nodes detected.

Highlights

There is a lack of comparative analyses on the use of carbon nanoparticle suspension injection (CNSI) and indocyanine green (ICG) tracer technology for lymph node detection and their perioperative safety in robotic radical gastrectomy
The mean number of lymph nodes retrieved in the CNSI group (48.44 ± 13.87) was higher than that in the ICG (39.19 ± 8.97) and control (35.28 ± 9.00) groups (F = 12.387, P < 0.001) (T = 3.002, P = 0.004/T = 4.542, P < 0.001), but the ICG group was not different than the control group in this regard (T = 1.663, P = 0.102)
The mean number of retrieved micro lymph nodes in the CNSI group was 13.24 ± 4.45, which was significantly higher than that in the ICG (5.74 ± 3.11) and control (5.66 ± 3.28) groups (F = 12.387, P < 0.001) (T = 3.002, P = 0.004/T = 4.542, P < 0.001), but no difference in retrieved micro lymph nodes was observed between the ICG and control groups (T = 1.663, P = 0.102) (Table 2)

Summary

Introduction

There is a lack of comparative analyses on the use of carbon nanoparticle suspension injection (CNSI) and indocyanine green (ICG) tracer technology for lymph node detection and their perioperative safety in robotic radical gastrectomy. Patients were assigned to the CNSI group, the ICG group, or the control group. Results Of the 93 patients analyzed, 34 were in the CNSI group, 27 were in the ICG group, and 32 were in the control group. The mean number of lymph nodes retrieved in the CNSI group (48.44) was higher than that in the ICG (39.19) and control (35.28) groups (P = 0.004; P < 0.001), and there was no difference between the ICG and control groups (P = 0.102). The mean number of micro lymph nodes retrieved in the CNSI group (13.24) was higher than that in the ICG (5.74) and control (5.66) groups (P < 0.001). CNSI was better than ICG in terms of improving the number of micro lymph nodes detected

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