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Intraoperative lymph node visualisation using near-infrared fluorescence (NIRF) and indocyanine green (ICG) tracing has been postulated to improve the overall lymph node yield, and to ensure the appropriate radicality, but its usefulness in the detection of metastatic lymph nodes remains unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We conducted a systematic review and meta-analysis of the relevant literature to ascertain the accuracy of ICG-guided lymphadenectomy in the detection of metastatic nodes in OC and GC. The primary outcomes were the sensitivity, specificity and diagnostic odds ratio of ICG-guided lymphadenectomy. Secondary outcomes included measurement of the effect of prior neoadjuvant chemotherapy (NAC), tumour characteristics and method of ICG administration. Summary receiver operator characteristic (SROC) curves were built to illustrate the relationship between the sensitivity of ICG and false positive rate.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>From an initial search of 6,302 articles, 15 studies met the criteria for inclusion, incorporating 4,004 patients. The pooled sensitivity for metastatic node detection was 69.1% (95% CI 56.5\u201379.3%), specificity 47.4% (38.0\u201356.9%), and DOR 2.02 (1.40\u20132.92). The SROC curve for diagnostic test accuracy yielded an area under the curve of 0.60. The use of NAC adversely affected the sensitivity of ICG 74.7% [59.2\u201385.8%] without NAC; 52.8% [43.6\u201361.9%] with NAC, <jats:italic>p<\/jats:italic>\u2009= 0.018). No significant difference in efficacy was demonstrated between pathological \u2018T\u2019 stage, or ICG administration method.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Our findings suggest that the oncological benefits of NIRF and ICG in the context of lymphadenectomy in OC and GC are limited, and that surgeons risk omitting a significant proportion of metastatic nodes if this technique is solely relied upon.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00464-025-11703-7","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T15:15:45Z","timestamp":1744989345000},"page":"3525-3538","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The use of indocyanine green and near-infrared fluorescence in the detection of metastatic lymph nodes during oesophageal and gastric cancer resection: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8110-0286","authenticated-orcid":false,"given":"Naim","family":"Slim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepika","family":"Anbu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ara","family":"Darzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Elson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Peters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,18]]},"reference":[{"key":"11703_CR1","unstructured":"John S, Broggio J (2019) Cancer survival in England: Adult, stage at diagnosis and childhood - patients followed up to 2018. 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Esophagus. https:\/\/doi.org\/10.1093\/dote\/doac016","journal-title":"Esophagus"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-11703-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-025-11703-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-11703-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T19:57:32Z","timestamp":1748375852000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-025-11703-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,18]]},"references-count":82,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["11703"],"URL":"https:\/\/doi.org\/10.1007\/s00464-025-11703-7","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,18]]},"assertion":[{"value":"8 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dr Naim Slim, Dr Deepika Anbu and Prof Ara Darzi have no conflicts of interest to disclose. Prof Daniel Elson and Dr Christopher Peters have received grants from Cancer Research UK and National Institute for Health Research during the conduct of this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}