Retrospective cohort study of laparoscopic ICG-Guided Lymphadenectomy in gastric cancer from a Western country center

Surg Endosc. 2022 Nov;36(11):8164-8169. doi: 10.1007/s00464-022-09258-y. Epub 2022 Apr 29.


Background: Indocyanine green (ICG) guided lymphadenectomy has been proposed has a technique to improve the lymphadenectomy of patients with gastric cancer. Nevertheless, experience with this procedure is scarce in Western countries.

Methods: A retrospective analytic study in a tertiary hospital in Spain was performed, comparing patients who underwent laparoscopic gastrectomy with (ICG cohort) and without (historic cohort) ICG guided lymphadenectomy.

Results: Thirty four patients were included (17 in each group). Although the number of positive nodes was similar in both groups (0.0 in the ICG cohort vs. 2 in the historic cohort, p = 0.119), the number of lymph nodes removed was higher in the ICG cohort (42.0 vs 28.0, p = 0.040). In the ICG cohort, more lymph nodes were positive for adenocarcinoma in the group of nodes that were positive for IGC (10.6% of the IGC + nodes vs. 1.9% in the ICG - nodes, p < 0.001).

Conclusions: ICG lymphadenectomy is a promising procedure that could improve the lymphadenectomy of patients with gastric cancer. ICG lymphadenectomy could be used to increase the number of lymph nodes removed in patients with a high-risk of nodal invasion or it could be used to reduce the surgical aggressiveness in fragile patients with a low-risk of nodal invasion.

Keywords: Gastrectomy; Gastric cancer; Indocyanine green; Indocyanine green lymphadenectomy; Lymphadenectomy.

MeSH terms

  • Gastrectomy / methods
  • Humans
  • Indocyanine Green
  • Laparoscopy* / methods
  • Lymph Node Excision / methods
  • Lymph Nodes / pathology
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy
  • Stomach Neoplasms* / pathology
  • Stomach Neoplasms* / surgery


  • Indocyanine Green