Intra-operatieve fluorescente beeldvorming van schildwachtklieren bij maagkankerpatienten

SLN technique has been used in the management of a variety of cancers to avoid unnecessary lymphadenectomy, and also in gastric cancer several studies support the validity of the SLN concept.
Fluorescent imaging using near-infrared probes is an innovative technique to directly visualize lymphatic pathways and lymph nodes.
Previous studies already used indocyanine green (ICG) in SLN mapping in gastric cancer and were able to successfully identify SLN with either preoperative submucosal and intraoperative subserosal injections around the tumor. Less false negative cases were found after preoperative submucosal injection. However, also a more widely spread of ICG in the lymphatic vessels with time, which results in the detection of more 2nd-tier nodes.
Recent publications showed good retention in the SLN with ICG coupled to a nanocolloid.
The aim of the study is to determine the proportion of gastric cancer patients in whom SLNs can be identified non-invasively with fluorescent imaging using ICG coupled to a nanocolloid (ICG:Nanocoll) during standard lymphadenectomy.

Fluorescent near-infrared imaging can accurately detect lymph nodes non-invasively during SLN mapping in gastric cancer patients.

The primary and secondary outcomes will be assessed during surgery and pathological assessment.

Standard lymphadectomy will be performed. During surgery, the near-infrared dye ICG:Nanocoll will be injected around the tumor and lymphatic pathways and lymph nodes will be visualized non-invasively using our experimental camerasystem.