Surgical Oncology 33 (2020) 30–31 Available online 2 January 2020 0960-7404/© 2020 Elsevier Ltd. All rights reserved. Transhiatal laparoscopic esophagectomy with extended lymphadenectomy guided by green-indocyanine imaging for adenocarcinoma of the esophagogastric junction Flavio Roberto Takeda * , Ulysses Ribeiro Junior, Rubens Antonio Aissar Sallum, Ivan Cecconello Department of Gastroenterology, Digestive Surgery Division, Sao Paulo Institute of Cancer, University of S~ ao Paulo Medical School, Brazil A R T I C L E INFO Keywords: Transhiatal Esophagectomy Indocyanine ABSTRACT Introduction: Surgical treatment for adenocarcinoma of the esophagogastric junction (AEGJ) has been long- established, from resection margins to the extension of lymphadenectomy [1,2,4]. The addition of cyanine dye, namely indocyanine green (ICG), to identify suspicious lymph nodes (LN) and evaluate organ vasculari- zation may improve results and outcomes [3]. Video: A 58-year-old female patient with Siewert type II AEGJ was administered mFLOX neoadjuvant treatment. After three cycles, she underwent surgical treatment. The day before surgery, an upper endoscopy was performed to inject 0.2 ml ICG 0.5 cm from the proximal and distal tumor margins. The patient underwent laparoscopic transhiatal esophagectomy with extended lymphadenectomy due to a 4 cm distal esophagus compromised margin. We describe the primary steps of the procedure and demonstrate the role of the ICG in the lymphadenectomy. Results: Surgery was carried out laparoscopically with a cervical approach (McKeown access), and posterior mediastinal gastric tube reconstruction and cervical gastroplasty were performed. During the standard lym- phadenectomy, we observed an ICG-positive LN in station 10, which was found positive in the subsequent pa- thology examination. After these fndings, we performed an extended lymphadenectomy through the splenic hilum. The fnal pathologic assessment was T3N2 (two perigastric and one positive LN at station 10 among 60 retrieved LN). The operative time was 360 min. The patient started a liquid diet on the seventh postoperative day, and she was discharged on the tenth postoperative day. Conclusions: ICG may be helpful to guide both extended lymphadenectomy and distal margin evaluation in transhiatal laparoscopic esophagectomy. Runtime of video 8mins and 8 sec. Funding This research did not receive any specifc grant from funding agencies in the public, commercial, or not-for-proft sectors. Disclosure Drs. Takeda FR, Ribeiro UR, Sallum RAA and Cecconello I have no conficts of interest or fnancial ties to disclose. Authorship statement All authors have made substantial contributions to all of the following: (1)the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) fnal approval of the version to be submitted. Declaration of competing interests The authors declare no competing fnancial interests. * Corresponding author. E-mail address: favio.takeda@hc.fm.usp.br (F.R. Takeda). Contents lists available at ScienceDirect Surgical Oncology journal homepage: http://www.elsevier.com/locate/suronc https://doi.org/10.1016/j.suronc.2019.12.009 Received 7 September 2019; Received in revised form 21 November 2019; Accepted 29 December 2019