Real-time indocyanine green lymphangiography in radical resection of right colon cancer allows the identification of chyle leakage

Daqing Cheng; Yunpeng Zhang; Bo Han; Peng Sun; Jue Wang; Quanjun Lin; Ming Xu

doi:10.5114/wo.2021.105076

eISSN: 1897-4309
ISSN: 1428-2526

Contemporary Oncology/Współczesna Onkologia

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1/2021
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abstract:

Case report

Real-time indocyanine green lymphangiography in radical resection of right colon cancer allows the identification of chyle leakage

Daqing Cheng

¹

,

Yunpeng Zhang

¹

,

Bo Han

²

,

Peng Sun

¹

,

Jue Wang

¹

,

Quanjun Lin

¹

,

Ming Xu

¹

Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Department of General Surgery, Key Laboratory for Translational Research and Innovative Therapeutics of Gastrointestinal Oncology, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Contemp Oncol (Pozn) 2021; 25 (1): 64-67

DOI: https://doi.org/10.5114/wo.2021.105076

Online publish date: 2021/04/15

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Chyle leakage can be caused by abdominal surgery and managed successfully without surgical treatment; however, no preventive measures are available. Therefore, we introduce a new method to prevent post-operative chyle leakage.

To investigate the role of indocyanine green (ICG) lymphangiography in the reduction of chyle ﬁstula formation after radical resection of right colon cancer.

Five patients with a diagnosis of right colon cancer undergoing laparoscopic radical colectomy with D3 lymph node dissection were examined in this study. At the end of the operation, two points of 2.5 mg ICG were injected subserosally at the proximal end of the anastomosis (1 ml per point). Then the surgical field was screened by using ICG ﬂuorescence to accurately locate the chyle leakage. Chyle leakage was noted and repaired with a Hem-O-Lock. The volume of output of each drain after surgery was measured daily until the patients were discharged.

We were able to observe ICG fluorescence in the lymphatic vessels within 3 minutes of ICG injection. This visualization allowed us to accurately locate and quickly repair chyle leakage within 5 minutes. Clinical observation after surgery and at a 1-month follow-up showed no chyle leakage in all 5 patients.

Indocyanine green lymphangiography can feasibly guide the location and repair of chyle leakage after right colon cancer resection.

keywords:

Real-time indocyanine green lymphangiography in radical resection of right colon cancer allows the identification of chyle leakage

Daqing Cheng 1 , Yunpeng Zhang 1 , Bo Han 2 , Peng Sun 1 , Jue Wang 1 , Quanjun Lin 1 , Ming Xu 1

indocyanine green, near infrared fluorescence, right colon cancer, chyle leakage

Daqing Cheng

¹

,

Yunpeng Zhang

¹

,

Bo Han

²

,

Peng Sun

¹

,

Jue Wang

¹

,

Quanjun Lin

¹

,

Ming Xu

¹