In this issue of JAMA Surgery, Kwon and colleagues¹ studied the use of fluorescent lymphography–guided lymphadenectomy during robotic gastrectomy for gastric cancer. They hypothesized that the peritumoral injection of indocyanine green (ICG) would allow for visualization of every draining lymph node from the primary lesion, therefore allowing a more complete and thorough lymphadenectomy. The day before the scheduled operation, they endoscopically injected 3 mg of ICG in the submucosa around the tumor in 40 patients who had a clinical stage I disease (T1N0M0, T1N1M0, or T2N0M0) according to the 7th staging system of the American Joint Commission on Cancer.² The gastrectomy was performed using the da Vinci Si Surgical system (Intuitive) equipped with the Firefly mode to acquire near-infrared (NIR) fluorescent images. After propensity score matching, the results in these 40 patients were compared with those of 40 historical control patients who underwent robotic gastrectomy without injection of ICG. The primary outcome was the number of retrieved lymph nodes in total and in each nodal station. The results of their study clearly showed that the use of NIR imaging determined the retrieval of a higher number of harvested lymph nodes per patient, and for stations 2, 6, 7, 8, and 9.

在本期JAMA Surgery中，Kwon及其同事¹研究了在胃癌机器人胃切除术中使用荧光淋巴造影术指导的淋巴结清扫术的用途。他们假设肿瘤周围注射吲哚菁绿（ICG）可以观察到原发灶的每个引流淋巴结，因此可以进行更彻底和彻底的淋巴结清扫术。在预定手术的前一天，根据美国联合委员会第七次分期系统，他们在40例临床上患有I期疾病（T1N0M0，T1N1M0或T2N0M0）的患者内镜下在肿瘤周围的粘膜下注射3 mg ICG。癌症。^2个使用配备萤火虫模式的da Vinci Si Surgical系统（直观）进行胃切除术，以获取近红外（NIR）荧光图像。倾向得分匹配后，将这40例患者的结果与40例历史对照患者的结果进行比较，这些患者在不注射ICG的情况下进行了机械胃切除术。主要结果是总的和每个淋巴结中回收的淋巴结数目。他们的研究结果清楚地表明，使用NIR成像可确定每位患者以及第2、6、7、8和9站的更多收集的淋巴结的回收。