Clin Colon Rectal Surg 2022; 35(04): 338-341
DOI: 10.1055/s-0042-1748888
Review Article

Mapping the Mesentery Using ICG

Manish Chand
1   Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
,
Meara Dean
2   University College Hospital, University College London Hospitals, London, United Kingdom
› Author Affiliations

Abstract

Indocyanine green (ICG) fluorescent imaging has been used in colorectal surgery to assess intraoperative blood flow to the colon. However, its use has expanded to allow imaging of the lymphatic drainage within the mesentery in cancer resections. This technique can been used for real-time visualization of lymph nodes, and the detection of sentinel lymph nodes, lateral sidewall nodes, metastatic lymph nodes, and peritoneal metastases. Ultimately, this provides a more informative map of the mesentery displaying lymphatics and blood flow. The technique is economical and easy to use by the surgeon intraoperatively. ICG lymphangiography has the potential to aid the surgeon to ensure complete lymphadenectomy is performed in cancer resections.



Publication History

Article published online:
10 August 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Jafari MD, Wexner SD, Martz JE. et al. Perfusion assessment in laparoscopic left-sided/anterior resection (PILLAR II): a multi-institutional study. J Am Coll Surg 2015; 220 (01) 82-92.e1
  • 2 Blanco-Colino R, Espin-Basany E. Intraoperative use of ICG fluorescence imaging to reduce the risk of anastomotic leakage in colorectal surgery: a systematic review and meta-analysis. Tech Coloproctol 2018; 22 (01) 15-23
  • 3 Cancer SIPAJCo. AJCC Cancer Staging Manual. 8th edition. 2017
  • 4 Pathologists TRCo. Dataset for Histopathological Reporting of Colon Cancer. 2017
  • 5 Keller DS, Ishizawa T, Cohen R, Chand M. Indocyanine green fluorescence imaging in colorectal surgery: overview, applications, and future directions. Lancet Gastroenterol Hepatol 2017; 2 (10) 757-766
  • 6 Garski TR, Staller BJ, Hepner G, Banka VS, Finney Jr RA. Adverse reactions after administration of indocyanine green. JAMA 1978; 240 (07) 635 DOI: 10.1001/jama.240.7.635b.
  • 7 Cahill RA, Ris F, Mortensen NJ. Near-infrared laparoscopy for real-time intra-operative arterial and lymphatic perfusion imaging. Colorectal Dis 2011; 13 (Suppl. 07) 12-17
  • 8 Soares A, L Lovat, Chand M. Intracorporeal lymph node mapping in colon cancer surgery. Eur J Surg Oncol 2019; 45 (12) 2316-2318
  • 9 Chand M, Keller DS, Joshi HM, Devoto L, Rodriguez-Justo M, Cohen R. Feasibility of fluorescence lymph node imaging in colon cancer: FLICC. Tech Coloproctol 2018; 22 (04) 271-277
  • 10 West NP, Hohenberger W, Weber K, Perrakis A, Finan PJ, Quirke P. Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol 2010; 28 (02) 272-278
  • 11 Watanabe J, Ota M, Suwa Y, Ishibe A, Masui H, Nagahori K. Real-time indocyanine green fluorescence imaging-guided complete mesocolic excision in laparoscopic flexural colon cancer surgery. Dis Colon Rectum 2016; 59 (07) 701-705
  • 12 Nishigori N, Koyama F, Nakagawa T. et al. Visualization of lymph/blood flow in laparoscopic colorectal cancer surgery by ICG fluorescence imaging (Lap-IGFI). Ann Surg Oncol 2016; 23 (Suppl. 02) S266-S274
  • 13 Nagata K, Endo S, Hidaka E, Tanaka J-I, Kudo S-E, Shiokawa A. Laparoscopic sentinel node mapping for colorectal cancer using infrared ray laparoscopy. Anticancer Res 2006; 26 (3B): 2307-2311
  • 14 Tuech JJ, Pessaux P, Regenet N, Bergamaschi R, Colson A. Sentinel lymph node mapping in colon cancer. Surg Endosc 2004; 18 (12) 1721-1729
  • 15 Tsioulias GJ, Wood TF, Morton DL, Bilchik AJ. Lymphatic mapping and focused analysis of sentinel lymph nodes upstage gastrointestinal neoplasms. Arch Surg 2000; 135 (08) 926-932
  • 16 van der Pas MHGM, Ankersmit M, Stockmann HBAC. et al. Laparoscopic sentinel lymph node identification in patients with colon carcinoma using a near-infrared dye: description of a new technique and feasibility study. J Laparoendosc Adv Surg Tech A 2013; 23 (04) 367-371
  • 17 Villegas-Tovar E, Jimenez-Lillo J, Jimenez-Valerio V. et al. Performance of Indocyanine green for sentinel lymph node mapping and lymph node metastasis in colorectal cancer: a diagnostic test accuracy meta-analysis. Surg Endosc 2020; 34 (03) 1035-1047
  • 18 Kazanowski M, Al Furajii H, Cahill RA. Near-infrared laparoscopic fluorescence for pelvic side wall delta mapping in patients with rectal cancer–‘PINPOINT’ nodal assessment. Colorectal Dis 2015; 17 (Suppl. 03) 32-35
  • 19 Zhou S-C, Tian Y-T, Wang X-W. et al. Application of indocyanine green-enhanced near-infrared fluorescence-guided imaging in laparoscopic lateral pelvic lymph node dissection for middle-low rectal cancer. World J Gastroenterol 2019; 25 (31) 4502-4511
  • 20 Liberale G, Galdon MG, Moreau M. et al. Ex vivo detection of tumoral lymph nodes of colorectal origin with fluorescence imaging after intraoperative intravenous injection of indocyanine green. J Surg Oncol 2016; 114 (03) 348-353
  • 21 Emile SH, Elfeki H, Shalaby M. et al. Sensitivity and specificity of indocyanine green near-infrared fluorescence imaging in detection of metastatic lymph nodes in colorectal cancer: systematic review and meta-analysis. J Surg Oncol 2017; 116 (06) 730-740
  • 22 Liberale G, Vankerckhove S, Caldon MG. et al; Group R&D for the Clinical Application of Fluorescence Imaging of the Jules Bordetʼs Institute.. Fluorescence imaging after indocyanine green injection for detection of peritoneal metastases in patients undergoing cytoreductive surgery for peritoneal carcinomatosis from colorectal cancer: a pilot study. Ann Surg 2016; 264 (06) 1110-1115
  • 23 Barabino G, Klein JP, Porcheron J, Grichine A, Coll JL, Cottier M. Intraoperative near-infrared fluorescence imaging using indocyanine green in colorectal carcinomatosis surgery: proof of concept. Eur J Surg Oncol 2016; 42 (12) 1931-1937
  • 24 Lieto E, Auricchio A, Cardella F. et al. Fluorescence-guided surgery in the combined treatment of peritoneal carcinomatosis from colorectal cancer: preliminary results and considerations. World J Surg 2018; 42 (04) 1154-1160
  • 25 de Valk KS, Deken MM, Schaap DP. et al. Dose-finding study of a CEA-targeting agent, SGM-101, for intraoperative fluorescence imaging of colorectal cancer. Ann Surg Oncol 2021; 28 (03) 1832-1844
  • 26 Boogerd LSF, Hoogstins CES, Schaap DP. et al. Safety and effectiveness of SGM-101, a fluorescent antibody targeting carcinoembryonic antigen, for intraoperative detection of colorectal cancer: a dose-escalation pilot study. Lancet Gastroenterol Hepatol 2018; 3 (03) 181-191