Intraoperative visualization of lymphatic flow along the ileocolic artery using ICG fluorescence imaging and its implications for right-sided colon cancer surgery

Uemura, Mamoru; Kusunoki, Chikako; Nakajo, Shoichiro; Osaki, Mao; Kusafuka, Hiroshi; Sekido, Yuki; Takeda, Mitsunobu; Hata, Tsuyoshi; Hamabe, Atsushi; Ogino, Takayuki; Miyoshi, Norikatsu; Kagawa, Yoshinori; Tei, Mitsuyoshi; Doki, Yuichiro; Eguchi, Hidetoshi

doi:https://doi.org/10.1007/s00464-025-11912-0

Intraoperative visualization of lymphatic flow along the ileocolic artery using ICG fluorescence imaging and its implications for right-sided colon cancer surgery

Uemura, Mamoru; Kusunoki, Chikako; Nakajo, Shoichiro et al.

Surgical Endoscopy, 2025

Number of Access:48（2025-09-09 02:02 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/102599

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Title	Intraoperative visualization of lymphatic flow along the ileocolic artery using ICG fluorescence imaging and its implications for right-sided colon cancer surgery
Creator	NRID 1000010528483 1000010528483 ORCID 0000-0001-6285-5619 0000-0001-6285-5619 researchmap permalink mamoruuemura mamoruuemura Scopus Author ID 36796497400 36796497400 CreatorName Uemura, Mamoru
	CreatorName Kusunoki, Chikako
	CreatorName Nakajo, Shoichiro
	CreatorName Osaki, Mao
	CreatorName Kusafuka, Hiroshi
	NRID 1000000781709 1000000781709 researchmap permalink 00781709 00781709 Scopus Author ID 57193691322 57193691322 CreatorName Sekido, Yuki
	NRID 1000090768962 1000090768962 researchmap permalink takeda27832 takeda27832 CreatorName Takeda, Mitsunobu
	NRID 1000080749747 1000080749747 researchmap permalink tsuyoshi_hata tsuyoshi_hata Scopus Author ID 57189996374 57189996374 CreatorName Hata, Tsuyoshi
	NRID 1000060621034 1000060621034 ORCID 0000-0001-5535-3514 0000-0001-5535-3514 researchmap permalink hamabe_atsushi hamabe_atsushi CreatorName Hamabe, Atsushi
	NRID 1000050597458 1000050597458 researchmap permalink togino04 togino04 Scopus Author ID 57200254430 57200254430 ORCID 0000-0001-5435-4144 0000-0001-5435-4144 CreatorName Ogino, Takayuki
	NRID 1000020528624 1000020528624 researchmap permalink nor nor Scopus Author ID 9242781300 9242781300 CreatorName Miyoshi, Norikatsu
	NRID 1000080571364 1000080571364 CreatorName Kagawa, Yoshinori
	CreatorName Tei, Mitsuyoshi
	NRID 1000020291445 1000020291445 researchmap permalink ydoki3251 ydoki3251 Scopus Author ID 7006390687 7006390687 CreatorName Doki, Yuichiro
	NRID 1000090542118 1000090542118 researchmap permalink abcdabcdabcd abcdabcdabcd Scopus Author ID 7101627772 7101627772 CreatorName Eguchi, Hidetoshi
Subject	Indocyanine green (ICG) fluorescence imaging
	Intraoperative navigation
	Lymph node dissection
	Lymphatic flow
	Right-sided colon cancer
Description	The version of record of this article, first published in Surgical Endoscopy (2025), is available online at Publisher’s website: https://doi.org/10.1007/s00464-025-11912-0.
Abstract	Background: In colorectal cancer surgery, especially for right-sided colon cancer, understanding the anatomical course of lymphatic flow along the ileocolic artery (ICA) is crucial for safe and oncologically adequate mesenteric dissection. However, the precise spatial relationship between the ICA and the accompanying lymphatic vessels has not been well-established. Methods: Seventeen patients undergoing laparoscopic right-sided colon cancer surgery were enrolled. Indocyanine green (ICG) was injected into the subserosal layer of the normal ascending colon wall peripheral to the ICA to visualize lymphatic flow. The distance between the lymphatic flow and the ICA was measured intraoperatively using ICG fluorescence imaging. Results: Lymphatic flow was successfully visualized in 15 of the 17 patients without any complications. After increasing the ICG injection volume to 1.0 mL, lymphatic flow along the ICA was clearly identified in all subsequent 13 cases. The median distance between the lymphatic flow and the ICA was 1.9 cm (interquartile range [IQR], 1.70–2.05 cm). In one case, the flow ran cranially to the ICA and was recorded as 0.0 cm. No major postoperative complications or mesenteric lymph node recurrence were observed during a median follow-up of 3.73 years. Conclusions: This study measured the distance between the ICA and the lymphatic flow that ran caudal to the artery, and found a distance of up to approximately 2 cm. These findings may serve as a useful anatomical reference for determining a safe and appropriate mesenteric dissection line in right-sided colon cancer surgery.
Publisher	Springer Science and Business Media LLC
Source Title	Surgical Endoscopy
Date of Issued	2025-07-26
Language	English
Handle URL	https://hdl.handle.net/11094/102599
PISSN	09302794
eISSN	14322218
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1007/s00464-025-11912-0
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Surgical Endoscopy. 2025
DC.title	Intraoperative visualization of lymphatic flow along the ileocolic artery using ICG fluorescence imaging and its implications for right-sided colon cancer surgery
DC.creator	Uemura, Mamoru
	Kusunoki, Chikako
	Nakajo, Shoichiro
	Osaki, Mao
	Kusafuka, Hiroshi
	Sekido, Yuki
	Takeda, Mitsunobu
	Hata, Tsuyoshi
	Hamabe, Atsushi
	Ogino, Takayuki
	Miyoshi, Norikatsu
	Kagawa, Yoshinori
	Tei, Mitsuyoshi
	Doki, Yuichiro
	Eguchi, Hidetoshi
DC.publisher	Springer Science and Business Media LLC
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2025-07-26
DC.identifier	https://doi.org/10.1007/s00464-025-11912-0
DC.subject	Indocyanine green (ICG) fluorescence imaging
	Intraoperative navigation
	Lymph node dissection
	Lymphatic flow
	Right-sided colon cancer
DC.description	The version of record of this article, first published in Surgical Endoscopy (2025), is available online at Publisher’s website: https://doi.org/10.1007/s00464-025-11912-0.
DCTERMS.abstract	Background: In colorectal cancer surgery, especially for right-sided colon cancer, understanding the anatomical course of lymphatic flow along the ileocolic artery (ICA) is crucial for safe and oncologically adequate mesenteric dissection. However, the precise spatial relationship between the ICA and the accompanying lymphatic vessels has not been well-established. Methods: Seventeen patients undergoing laparoscopic right-sided colon cancer surgery were enrolled. Indocyanine green (ICG) was injected into the subserosal layer of the normal ascending colon wall peripheral to the ICA to visualize lymphatic flow. The distance between the lymphatic flow and the ICA was measured intraoperatively using ICG fluorescence imaging. Results: Lymphatic flow was successfully visualized in 15 of the 17 patients without any complications. After increasing the ICG injection volume to 1.0 mL, lymphatic flow along the ICA was clearly identified in all subsequent 13 cases. The median distance between the lymphatic flow and the ICA was 1.9 cm (interquartile range [IQR], 1.70–2.05 cm). In one case, the flow ran cranially to the ICA and was recorded as 0.0 cm. No major postoperative complications or mesenteric lymph node recurrence were observed during a median follow-up of 3.73 years. Conclusions: This study measured the distance between the ICA and the lymphatic flow that ran caudal to the artery, and found a distance of up to approximately 2 cm. These findings may serve as a useful anatomical reference for determining a safe and appropriate mesenteric dissection line in right-sided colon cancer surgery.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	102599
citation_title	Intraoperative visualization of lymphatic flow along the ileocolic artery using ICG fluorescence imaging and its implications for right-sided colon cancer surgery
citation_author	Uemura, Mamoru
	Kusunoki, Chikako
	Nakajo, Shoichiro
	Osaki, Mao
	Kusafuka, Hiroshi
	Sekido, Yuki
	Takeda, Mitsunobu
	Hata, Tsuyoshi
	Hamabe, Atsushi
	Ogino, Takayuki
	Miyoshi, Norikatsu
	Kagawa, Yoshinori
	Tei, Mitsuyoshi
	Doki, Yuichiro
	Eguchi, Hidetoshi
citation_publisher	Springer Science and Business Media LLC
citation_language	English
citation_date	2025-07-26
citation_journal_title	Surgical Endoscopy
citation_doi	https://doi.org/10.1007/s00464-025-11912-0
citation_public_url	https://hdl.handle.net/11094/102599

Intraoperative visualization of lymphatic flow along the ileocolic artery using ICG fluorescence imaging and its implications for right-sided colon cancer surgery

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