Perioperative outcomes and survival of indocyanine green guided minimally esophagectomy in patients with esophageal cancer: a retrospective comparison study

Abstract

Background With the expansion of clinical investigations on intraoperative fluorescence imaging in esophageal cancer, the advantages of this technique in precise lymph node identification and dissection have been demonstrated. However, certain issues remain unaddressed. This study aimed to evaluate the safety and feasibility of indocyanine green (ICG)-guided lymph node dissection in radical esophagectomy for patients with esophageal squamous cell carcinoma and assess its long-term outcomes, thereby providing a theoretical basis for further research. Results A total of 176 patients were included in the statistical analysis. The two groups were comparable in terms of basic characteristics. The mean number of Dissected lymph nodes by pathologist in the ICG Group was significantly higher than that in the Non-ICG Group (27.7 ± 2.1 vs. 20.5 ± 1.4, P < 0.001), The number of positive lymph node station(metastasis mediastinal lymph nodes) in ICG group was higher than that in non-ICG Group. There was no significant difference in results of postoperative complications between the two groups (P > 0.05).The non-ICG group exhibited higher event rates and poorer survival outcomes in both DFS and OS compared to the ICG group, with statistically significant differences observed(P < 0.005). Conclusions ICG-guided lymph node dissection during minimally invasive esophageal cancer surgery can significantly improve patient survival outcomes without increasing the rate of relevant postoperative complications.