{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T04:43:13Z","timestamp":1777869793269,"version":"3.51.4"},"reference-count":43,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Introduction: Robotic gastrectomy is increasingly used in the surgical management of gastric cancer. Indocyanine green (ICG) near-infrared fluorescence imaging has emerged as a technique that enables real-time visualization of lymphatic drainage pathways, potentially facilitating more precise and individualized lymph node dissection. However, the clinical value of ICG-guided fluorescent lymphography during robotic gastrectomy remains incompletely established. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, Embase, Scopus, and the Cochrane Library were searched from database inception to 31 January 2026 for comparative studies evaluating ICG-guided fluorescent lymphography versus standard robotic gastrectomy for gastric cancer. Statistical analyses were performed using R (version 4.4.2) and the meta package. Results: Six studies, including 406 patients, met the inclusion criteria. Use of ICG was associated with a higher number of retrieved lymph nodes (mean difference [MD] 8.48; 95% CI 4.61\u201312.36; p = 0.001; I2 = 55.5%). Operative time was modestly shorter in the ICG group (MD \u221210.84 min; 95% CI \u221221.08 to \u22120.61; p = 0.038). There were no significant differences in intraoperative blood loss (MD \u22124.02 mL; p = 0.289), length of hospital stay (MD \u22120.82 days; p = 0.131), or postoperative complications (odds ratio 0.83; 95% CI 0.46\u20131.49; p = 0.534). Conclusions: ICG-guided fluorescence imaging during robotic gastrectomy is associated with increased lymph node retrieval and a small reduction in operative time without evidence of increased perioperative morbidity. Larger prospective studies are required to confirm these findings and to evaluate long-term oncologic outcomes.<\/jats:p>","DOI":"10.3390\/jpm16050243","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T14:35:53Z","timestamp":1777559753000},"page":"243","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Value of Fluorescent Lymphography with Indocyanine Green During Robotic Surgery for Gastric Cancer in Guided Lymph Node Dissection: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3806-028X","authenticated-orcid":false,"given":"Dimitra V.","family":"Peristeri","sequence":"first","affiliation":[{"name":"Department of Bariatric and Upper GI Surgery, Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton, Somerset TA1 5DA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9549-053X","authenticated-orcid":false,"given":"Dimitrios N.","family":"Raptis","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, General Hospital of Thessaloniki \u201cG. Gennimatas\u2019\u2019, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Mantzoros","sequence":"additional","affiliation":[{"name":"4th Surgical Department, Papanikolaou General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7046-0112","authenticated-orcid":false,"given":"Dimitrios","family":"Schizas","sequence":"additional","affiliation":[{"name":"1st Department of Surgery, National and Kapodistrian University of Athens, 17676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8077-3254","authenticated-orcid":false,"given":"Alexandros-Georgios I.","family":"Asimakopoulos","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Hygiene and Epidemiology, School of Medicine, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1185-4342","authenticated-orcid":false,"given":"Eirini","family":"Papadopoulou","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, General Hospital of Thessaloniki \u201cG. Gennimatas\u2019\u2019, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios D.","family":"Lianos","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital of Ioannina, 45110 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Papaziogas","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, General Hospital of Thessaloniki \u201cG. Gennimatas\u2019\u2019, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasileios","family":"Papaziogas","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, General Hospital of Thessaloniki \u201cG. Gennimatas\u2019\u2019, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.cgh.2019.07.045","article-title":"Burden of Gastric Cancer","volume":"18","author":"Thrift","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_2","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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