Page 28 - Fluorescence-guided cancer surgery

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Chapter 2
2 wavelength isolated light sources: a “white” light source, generating 26,600 lx of 400 to 650 nm light, and a “near-infrared” light source, generating 1.08 mW/came of ≈760 nm light. Color video and NIR uorescence images are simultaneously acquired and displayed in real time using custom optics and software that separate the color video and NIR uorescence images. A pseudo- colored (lime green) merged image of the color video and NIR uorescence images is also displayed. The imaging head is attached to a exible gooseneck arm, which permits positioning of the imaging head at extreme angles virtually anywhere over the surgical eld. For intraoperative use, the imaging head and imaging system pole stand are wrapped in a sterile shield and drape (Medical Technique Inc., Tucson, AZ).
RESULTS
Patient characteristics
Twenty-six patients with gastric cancer undergoing partial or total gastrectomy were included in this study (Table 1). Median age was 64 years (range 30–82) and 19 patients were male. T-stadium of tumors were pTx, pT1, pT2, pT3, and pT4 in respectively 2, 5, 5, 10, and 4 patients. Median tumor size was 31 mm (range 10 – 90). Tumors were located in the cardia in 8, corpus in 6 and antrum in 12 patients. Eleven patients underwent a total gastrectomy, 14 patients underwent a partial gastrectomy and in 1 patient no resection was performed due to metastasized disease. Twenty-three patients received neoadjuvant chemotherapy consisting of Epirubicine, Oxaliplatin and Capecitabine or Epirubicine, Cisplatine and Capecitabine.
Sentinel lymph node detection
Three patients (#3, #12, and #16) did not receive an injection of ICG:Nanocoll because metastatic disease was found during surgery. In 1 patient (#8), ICG:Nanocoll was injected through the wall of the stomach. After this technical failure, this patient was excluded for further analysis.