Indocyanine green fluorescence in gastrointestinal surgery: Appraisal of current evidence

Table 5 Studies on sentinel nodal navigation in early gastric cancer

Ref.	Country	Study type	Patient	ICG dose	Surgery	Mean SN yield	Results	Long term outcome
Isozaki et al[56], 2019	Japan	Multicenter retrospective cohort	100	Intraop endoscopic submucosal 1 mL 2.5% ICG 4 sites wait 15 min. Sentinel node biopsy followed by frozen	Open SNNS/DiG WDG: 3; 1/2 DG: 18; PPG: 19; SG: 31; LR: 29	3.8	Sensitivity: 85.7%. Specificity: 98.9%. Accuracy: 98%	5-yr OS: 89.6%. Gastric cancer specific survival: 98.5%
An et al[54], 2020	Korea	Multicenter RCT	580 patients; LSG: 292; LSNNS: 245	Dual tracer, ICG 2.5 mg/mL, 2 ml, and 99mTc-HSA, 2 mL	LSG group: Open: 3; LSG: 266. LSNNS group: LSNNS: 210	9	SBD: SB nodes: 59.7%; hot nodes: 23.4%; hot and green: 12%; green nodes: 4.9%. Operative time: LSG: 180 min; LSNNS: 192.5 min. Upstaging: 7.4%	NA
Miyashiro et al[55], 2014	Japan	Multicenter RCT	440 patients suspended	Serosal injection 4-5 mL, 25 mg/5 mL ICG	Sentinel node biopsy followed by gastrectomy with lymphadenectomy	4	False negative: 46.4%	NA

RCT: Randomized controlled trial; ICG: Indocyanine green; SNSS: Sentinel node navigation surgery; WDG: Wide-extent distal gastrectomy; LR: Local resection of stomach; SG: Segmental gastrectomy; PPG: Pylorus preserving gastrectomy; OS: Overall survival; DiG: Diminished gastrectomy; SBD: Sentinel basin dissection; HN: Hot nodes; SB: Sentinel basin; LSG: Laparoscopic standard gastrectomy; LSNNS: Laparoscopic sentinel node navigation surgery.