Journal of Peritoneum (and other serosal surfaces) 2018; volume 3:97 [Journal of Peritoneum (and other serosal surfaces) 2018; 3:97] [page 15] Abstract Sentinel lymph node (LN) biopsy is a common practice to determinate if a lymphadenectomy is needed in various malignan- cies. Recent studies have investigated the possibilities to extend sentinel LN biopsy in gastric cancer. Indocyanine green (ICG) is a diagnostic reagent recently introduce in sentinel LN biopsy field. This review aims to determinate the feasibility to used ICG to detect sentinel LN in gastric cancer. Introduction Indocyanine green (ICG) is a diagnostic reagent used since long time for assessment of hepatic function and cardiac output. It is also used as a dye tracer for gastric cancer as the blue dye. Unfortunately ICG was not well observed by naked eyes, than devices to better detect ICG were developed. ICG absorbs light in the near infrared range between 600 to 900 nm and emits fluores- cence between 750 to 950 nm. Near infrared fluorescence imaging system developed are the following: Photodynamic Eye (PDE, Hamamatsu Photonics, Hamamatsu, Japan) imaging camera sys- tem, 1 SPY system (Novadaq Technologies, Concord, ON, Canada) and the Fluobeam (Fluoptics, Grenoble, France). Several others imaging systems have been used in clinical studies but are not available in the market as: HyperEye (HEMS) 2 (Kochi Medical School, Kochi, Japan), the FLARE and Mini-FLARE 3 (Beth Israel Deaconess Hospital, Boston, MA, USA), the FDPM imager 4 (Texas Medical Center, Houston, TX, USA), and a prototype cam- era system from Munich 5 (Technical University Munich, Munich, Germany and SurgOptix Inc., Redwood Shores, CA, USA). Sentinel LN is defined as a node that directly receives lym- phatic drainage from a primary tumor. 6 Sentinel LN biopsy is a common practice to determinate if a lymphadenectomy is needed in various malignancies, for example breast and skin cancer. Recently gastric cancer sentinel node biopsy was investigated. Prospective studies have successfully demonstrated the feasibility of sentinel LN biopsy in gastric cancer. 7-10 Except for JCOG0302 trial that shown high false negatives, that was probably because just one plan for intraoperative histological examination was not an appropriate method. 11 Various methods are described to map sentinel LN as: isosulfan blue and ICG were used as dye tracer. Successively radioactive tracer with Tecnezium-99 colloid was introduced, alone or associate with dye tracer. Dual tracer method for sentinel LN mapping is confirmed to be safe and effective. 12 Recently ICG fluorescence method was introduced, using near infrared light to detect sentinel LN. Our goal is to determinate the feasibility of single tracer ICG sentinel LN mapping in gastric cancer patients. Methods of research Literature search strategy We carried out electronic research during July 2017. PubMed, EMBASE and Cochrane Library database were examined. Key words for the research were gastric or stomach cancer, indocya- nine green, and lymph node. Only English language articles were included. References from included studies were screened to search for additional potentially relevant articles. Inclusion and exclusion criteria We consider as inclusions criteria the following: original arti- cles concerning LN navigation surgery in gastric cancer using ICG with near infrared light. Exclusion criteria are as follow: reviews, case reports, meta- analyses, abstract, posters or letters; animal experimental trial; dye Correspondence: Beatrice Molteni, Department of Surgery, ASST Spedali Civili Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy. E-mail: beatrice.molteni@hotmail.com Key words: Gastric cancer; indocyanine green; sentinel lymph node. Contributions: MB and PP, study and manuscript conception, online search and article selection; BG, re-checking and solve doubt; MS, AMS, BS, CF, AL, PN, revising and contribute to final version. Conflict of interest: the authors declare no potential conflict of interest. Received for publication: 26 February 2018. Revision received: 25 March 2018. Accepted for publication: 19 April 2018. ©Copyright B. Molteni et al., 2018 Licensee PAGEPress, Italy Journal of Peritoneum (and other serosal surfaces) 2018; 3:97 doi:10.4081/joper.2018.97 This article is distributed under the terms of the Creative Commons Attribution Noncommercial License (by-nc 4.0) which permits any non- commercial use, distribution, and reproduction in any medium, provid- ed the original author(s) and source are credited. Gastric cancer indocyanine green lymph node navigation surgery: systematic review Beatrice Molteni, 1 Paola Porsio, 1 Sarah Molfino, 1 Marie Sophie Alfano, 1 Sara Benedicenti, 1 Fausto Catena, 2 Luca Ansaloni, 3 Nazario Portolani, 1 Gianluca Baiocchi 1 1 Department of Surgery, ASST Spedali Civili Brescia, Brescia; 2 Department of Emergency Surgery, Maggiore Hospital, Parma; 3 Department of General Surgery, Cesena Hospital, Cesena, Italy Non-commercial use only