Sun YW, Liang MJ, Wang XZ, Dong WT, Sun F, Lu XF, Wang F, Liu S, Wang M, Shen XF, Ai SC, Guan WX. Indocyanine green fluorescence imaging in gastric cancer: Clinical efficacy, technical innovations, and future perspectives. World J Gastrointest Surg 2025; 17(11): 109964 [DOI: 10.4240/wjgs.v17.i11.109964]
Corresponding Author of This Article
Shi-Chao Ai, MD, PhD, Division of Gastric Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, Jiangsu Province, China. medasc@smail.nju.edu.cn
Research Domain of This Article
Medicine, Research & Experimental
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 27, 2025 (publication date) through Nov 25, 2025
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Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Sun YW, Liang MJ, Wang XZ, Dong WT, Sun F, Lu XF, Wang F, Liu S, Wang M, Shen XF, Ai SC, Guan WX. Indocyanine green fluorescence imaging in gastric cancer: Clinical efficacy, technical innovations, and future perspectives. World J Gastrointest Surg 2025; 17(11): 109964 [DOI: 10.4240/wjgs.v17.i11.109964]
Yi-Wen Sun, Meng-Jie Liang, Xing-Zhou Wang, Feng Sun, Xiao-Feng Lu, Feng Wang, Song Liu, Meng Wang, Xiao-Fei Shen, Shi-Chao Ai, Wen-Xian Guan, Division of Gastric Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
Wen-Ting Dong, Medical School, Southeast University, Nanjing 210008, Jiangsu Province, China
Co-first authors: Yi-Wen Sun and Meng-Jie Liang.
Co-corresponding authors: Shi-Chao Ai and Wen-Xian Guan.
Author contributions: Sun YW and Liang MJ contributed equally to this article, they are the co-first authors of this manuscript; Wang XZ, Dong WT, Sun F, Lu XF, Wang F, Liu S, Wang M, and Shen XF collected relevant literature; Ai SC and Guan WX contributed equally to guiding the experimental design, data interpretation, and manuscript discussion, they contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors read and approved the final manuscript.
Supported by the National Natural Science Foundation of China, No. 82473154 and No. 82372805; Jiangsu Province Basic Research Special Fund (Soft Science Research) Special Funding, No. BK20210022; and Nanjing Municipal Special Fund for Health Science and Technology Development, No. YKK21078.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shi-Chao Ai, MD, PhD, Division of Gastric Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, Jiangsu Province, China. medasc@smail.nju.edu.cn
Received: May 28, 2025 Revised: June 16, 2025 Accepted: October 14, 2025 Published online: November 27, 2025 Processing time: 181 Days and 19.7 Hours
Abstract
Gastric cancer (GC) ranks among the most common and deadly malignancies globally. Surgical resection with lymph node (LN) dissection is the primary treatment. The accuracy of LN dissection is essential to reduce postoperative complications and mortality. Therefore, improving the quality of LN dissection in GC surgery and refining postoperative LN staging have been the focus of clinical attention. Indocyanine green (ICG) fluorescence imaging serves as a vital clinical tracing technique in GC surgery. It enables accurate tumor localization, enhances the completeness of LN dissection, and evaluates anastomotic blood supply after digestive tract reconstruction. These benefits collectively improve surgical outcomes and lower recurrence rates. This article examines the principles of ICG fluorescence imaging and its necessity in GC tracing surgery. Compared to conventional tracers, ICG offers superior safety and lower toxicity, with robust evidence supporting its clinical efficacy. This technology represents a paradigm shift in GC surgery. Current studies optimize ICG delivery protocols, such as injection time and dose, and integrate it with emerging technologies like robotic systems to improve LN detection rates. This article demonstrates the safety and efficacy of ICG as a tracer, which is poised to advance the precision of GC surgery and improve patient outcomes.
Core Tip: The accuracy of lymph node dissection is crucial for reducing postoperative complications and mortality in gastric cancer (GC). Indocyanine green fluorescence staining, as a clinical tracer technique, plays an important role in GC surgery. It enables accurate tumor localization, enhances the thoroughness of lymph node dissection, and facilitates assessment of anastomotic blood supply following digestive tract reconstruction. These functions contribute to improved surgical outcomes and reduced recurrence rates. This review highlights the safety and efficacy of indocyanine green as a tracer, which is expected to enhance surgical precision and improve patient prognosis in GC.
