Indocyanine green fluorescence in gastrointestinal surgery: Appraisal of current evidence

Table 4 Studies on lymphatic mapping in esophageal and gastric surgery

Ref.	Country	Study type	Patient	Device	ICG dose and time	Surgery	Results	Long term outcome
Esophageal
Hachey et al[48], 2016	United States	Prospective PFS	EAC: 9	NOVADAQ, Stryker	2.5 mg/mL, 1 cc, 4 sites, endoscopic injection diluted with sterile water/HSA 25%	Ivor Lewis esophagectomy	6/9 patients showed 2-6 regional NIR +	NA
Park et al[49], 2018	Korea	Prospective PFS	ESCC, cT1: 29	Firefly, Da Vinci	0.5 mg/m, 0.5 m: Each quadrant 1 d prior	Robotic Mckeown esophagectomy	High NPV	NA
Stomach
Chen et al[58], 2020	China	RCT	ICG 129; non-ICG: 129	NOVADAQ, Stryker	Submucosal endoscopic 1 d prior 2 mL, 0.5 mL/quadrant 0.625 mg/m	Laparoscopic distal and total gastrectomy	Lymph node yield, mean ± SD: ICG: 50.5 ± 15.9; non-ICG: 42.0 ± 10.3	3-yr: DFS: 81.4% vs 68.2%; OS: 86.0% vs 73.6%
Park et al[51], 2020	Korea	Prospective feasibility study, PSM	ICG: 20; non-ICG: 60	NOVADAQ, Stryker	Endoscopic sub-mucosal 0.1 mg/mL, 1 mL 5 sites	Laparoscopic distal gastrectomy, station 6 dissection	ICG vs non-CIG lymph node yield 30.15 vs 32.55, bleeding events 4 (20.0) vs 41 (68.3)	NA
Cianchi et al[53], 2020	Italy	Retrospective, PSM	ICG: 37; non-ICG: 37	Firefly, Da Vinci	Endoscopic sub-mucosal 0.1 mg/mL, 0.5 mL, 4 quatrants	Robotic distal or total gastrectomy	Operative time mean ± SD: 293.1 ± 6 vs 321.2 ± 77.8 harvested lymph nodes: vs 50.8 ± 17	NA
Ushimaru et al[52], 2019	Japan	Retrospective, PSM	ICG: 84; non-ICG: 84	NIR, Karl storz	Endoscopic submucosal 0.05 mg/mL, 10 mL, 4 sites	Laparoscopic distal gastrectomy	Operative time mean ± SD: 206.1 ± 5.0 vs 237.0 ± 5.0, harvested lymph nodes: 47.5 vs 42.6	NA

ICG: Indocyanine green; PSM: Propensity score matching; PFS: Progression free survival; HAS: Human albumin solution; ESCC: Esophageal squamous cell carcinoma; EAC: Esophageal adenocarcinoma; DNIR: Near infra-red; DFS: Disease free survival; OS: Overall survival; NA: Not available.