THE ROLE OF INTRAOPERATIVE NAVIGATION AND FLUORESCENCE IMAGING IN CONTEMPORARY CANCER SURGERY: A LITERATURE REVIEW

Aman Berkinbay, T. Zholdassova, A. Uskenbayeva, S. Faiziyeva, O.T. Ibekenov, Alisher Kozhamkul

2026

Full text Open access: Hybrid Metadata (CSL-JSON)
DOI 10.52532/3135-3940-2026-2-721
Data confidence 70 medium
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Abstract

Relevance: Intraoperative navigation using fluorescence imaging is mentioned in 68.6% of modern studies on surgical treatment of cancer and is considered one of the most promising methods for improving surgical accuracy. This technology enhances tumor visualization, increases the radicality of resection, and reduces the incidence of postoperative complications.The study aimed to analyze current evidence on the role of intraoperative navigation and fluorescence imaging in cancer surgery and to evaluate their impact on surgical outcomes.Materials and Methods: A literature review of 36 studies published between 2020 and 2025 was performed. The literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar. The study included data from 12,846 patients. The assessed outcomes included the rate of R0 resection, detection of additional tumor lesions, quality of lymph node dissection, anastomotic leakage, postoperative complications, and odds ratios.Results: Fluorescence-guided navigation increased the R0 resection rate from 78.9 ± 8.5% to 91.4 ± 6.8% (OR = 2.84; 95% CI 1.91-4.26; p < 0.001) and improved the detection of additional tumor lesions from 4.3 ± 2.1% to 18.7 ± 7.4% (OR = 4.12; 95% CI 2.37-7.15; p < 0.001). In colorectal surgery, the anastomotic leakage rate decreased from 10.9 ± 3.8% to 5.8 ± 2.3% (OR = 0.48; 95% CI 0.31-0.74; p = 0.004). In gastric cancer surgery, the number of removed lymph nodes increased from 27.8 ± 4.9 to 34.6 ± 5.2, while the likelihood of adequate D2 lymphadenectomy increased more than threefold (OR = 3.17; 95% CI 1.82-5.51; p < 0.001).Conclusion: Intraoperative navigation using fluorescence imaging significantly improves the outcomes of cancer surgeries. The most promising directions include combining this technology with 3D navigation, augmented reality, and artificial intelligence.