PMID- 35091859
OWN - NLM
STAT- MEDLINE
DCOM- 20220613
LR  - 20240213
IS  - 1873-4626 (Electronic)
IS  - 1091-255X (Linking)
VI  - 26
IP  - 6
DP  - 2022 Jun
TI  - Intraoperative Tumor Identification During Laparoscopic Distal Gastrectomy: a 
      Novel Fluorescent Clip Marking Versus Metal Clip Marking and Intraoperative 
      Gastroscope.
PG  - 1132-1139
LID - 10.1007/s11605-021-05208-6 [doi]
AB  - BACKGROUND: In complete laparoscopic distal gastrectomy, the gastric resection 
      line is difficult to determine due to a lack of tactile sensation. The use of 
      intraoperative gastroscopy and intraoperative radiography has been reported, but 
      the burden on personnel and technical complexity present impediments. In our 
      department, based on lesion extent determined with preoperative gastroscopy, a 
      fluorescent clip is used to mark the oral side of the lesion, which is resected 
      after confirmation with a fluorescent laparoscopic system. In this study, we 
      investigated the efficacy of fluorescent clip marking (FCM) in achieving an 
      accurate resection line and reducing the operative time. METHODS: Fifty-six 
      patients with gastric cancer who underwent complete laparoscopic distal 
      gastrectomy from January 2018 to March 2021 were divided into two groups: the FCM 
      group (n = 32) and the conventional metal clip marking and intraoperative 
      gastroscopy (MCMG) group (n = 24). Short-term outcomes, including the resection 
      margins, gastric resection time, and operative time, were compared and examined. 
      RESULTS: The fluorescent clips were visible in all cases, and all stumps were 
      negative according to permanent preparations. The operative times for FCM and 
      MCMG were 350 (216-533) vs. 373.5 (258-651) min, respectively, with no 
      significant difference (p = 0.316), while the gastric resection times were 636.5 
      (321-2572) vs. 1457.5 (843-4973) s, respectively, and were significantly shorter 
      in the FCM group (p < 0.0001). CONCLUSIONS: FCM shortened the gastric resection 
      time and could possibly shorten the operative time. FCM is feasible and safe and 
      can potentially be used as a tumor-marking agent to determine accurate surgical 
      resection lines. CLINICAL TRIAL REGISTRATION: Examination of Gastric Cancer, 
      Research Ethics Committee of the Kawaguchi Municipal Medical Centre (Saitama, 
      Japan), approval number: 2019-33. 
      https://kawaguchi-mmc.org/wp-content/uploads/clinicalresearch-r02.pdf.
CI  - (c) 2022. The Society for Surgery of the Alimentary Tract.
FAU - Hara, Keigo
AU  - Hara K
AD  - Department of Digestive Surgery, Kawaguchi Municipal Medical Centre, Kawaguchi 
      City, Saitama, Nishiaraijuku, 180333-0833, Japan.
FAU - Ryu, Shunjin
AU  - Ryu S
AUID- ORCID: 0000-0001-7484-049X
AD  - Department of Digestive Surgery, Kawaguchi Municipal Medical Centre, Kawaguchi 
      City, Saitama, Nishiaraijuku, 180333-0833, Japan. systematic.ryu1121@gmail.com.
FAU - Okamoto, Atsuko
AU  - Okamoto A
AD  - Department of Digestive Surgery, Kawaguchi Municipal Medical Centre, Kawaguchi 
      City, Saitama, Nishiaraijuku, 180333-0833, Japan.
FAU - Kitagawa, Takahiro
AU  - Kitagawa T
AD  - Department of Digestive Surgery, Kawaguchi Municipal Medical Centre, Kawaguchi 
      City, Saitama, Nishiaraijuku, 180333-0833, Japan.
FAU - Marukuchi, Rui
AU  - Marukuchi R
AD  - Department of Digestive Surgery, Kawaguchi Municipal Medical Centre, Kawaguchi 
      City, Saitama, Nishiaraijuku, 180333-0833, Japan.
FAU - Ito, Ryusuke
AU  - Ito R
AD  - Department of Digestive Surgery, Kawaguchi Municipal Medical Centre, Kawaguchi 
      City, Saitama, Nishiaraijuku, 180333-0833, Japan.
FAU - Nakabayashi, Yukio
AU  - Nakabayashi Y
AD  - Department of Digestive Surgery, Kawaguchi Municipal Medical Centre, Kawaguchi 
      City, Saitama, Nishiaraijuku, 180333-0833, Japan.
LA  - eng
PT  - Journal Article
DEP - 20220128
PL  - Netherlands
TA  - J Gastrointest Surg
JT  - Journal of gastrointestinal surgery : official journal of the Society for Surgery 
      of the Alimentary Tract
JID - 9706084
RN  - 0 (Coloring Agents)
SB  - IM
MH  - Coloring Agents
MH  - Gastrectomy
MH  - Gastroscopes
MH  - Gastroscopy
MH  - Humans
MH  - *Laparoscopy
MH  - Retrospective Studies
MH  - *Stomach Neoplasms/diagnostic imaging/surgery
MH  - Surgical Instruments
OTO - NOTNLM
OT  - Fluorescent clip
OT  - Fluorescent laparoscopy
OT  - Gastric cancer
OT  - Laparoscopic distal gastrectomy
EDAT- 2022/01/30 06:00
MHDA- 2022/06/14 06:00
CRDT- 2022/01/29 05:46
PHST- 2021/07/30 00:00 [received]
PHST- 2021/11/18 00:00 [accepted]
PHST- 2022/01/30 06:00 [pubmed]
PHST- 2022/06/14 06:00 [medline]
PHST- 2022/01/29 05:46 [entrez]
AID - S1091-255X(23)05652-4 [pii]
AID - 10.1007/s11605-021-05208-6 [doi]
PST - ppublish
SO  - J Gastrointest Surg. 2022 Jun;26(6):1132-1139. doi: 10.1007/s11605-021-05208-6. 
      Epub 2022 Jan 28.