Infrared ray electronic endoscopy combined with indocyanine green injection for detection of sentinel nodes of patients with gastric cancer

Background: To avoid unnecessary lymphadenectomy in patients with cancer accurate diagnosis of the sentinel lymph node (SLN) is important. Methods: This report examined the initial clinical use of infrared ray electronic endoscopy (IREE) combined with indocyanine green (ICG) injection for SLN detection in 84 patients with gastric cancer not invading the subserosa (75 T1 N0 M0 and nine T2 N0 M0 tumours, according to tumour node metastasis classification). Results: There were no adverse events after injection of ICG. At least one SLN was detected in all but one patient by both ICG injection alone and by IREE with ICG. Eleven of the 84 patients had lymph node metastasis. SLNs detected by ICG injection alone did not include metastases in four of 11 patients, whereas IREE with ICG detected SLNs containing lymph node metastases in all 11 patients. Moreover, SLNs illuminated by IREE with ICG included all metastases among the 105 regional lymph nodes in the 11 patients; no metastatic lymph nodes were identified among 154 non-SLNs. Conclusion: IREE combined with ICG injection may efficiently detect SLNs that contain metastases in patients with gastric cancer.