Dye-Guided surgery may spare healthy lymph nodes in esophageal cancer

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria 1. Aged 18 to 75 years, regardless of gender; 2. Histopathologically confirmed esophageal squamous cell carcinoma or adenocarcinoma by endoscopic biopsy (including esophagogastric junction carcinoma, Siewert type I/II); 3. Preoperative clinical stage cT1-3N0M0 (based on contrast-enhanced CT ± PET-CT ± endoscopic ultrasound evaluation); 4. No prior neoadjuvant therapy of any form (including chemotherapy, radiotherapy, chemoradiotherapy, immunotherapy, targeted therapy, etc.); 5. Scheduled for minimally invasive radical esophagectomy (combined thoracoscopic and laparoscopic McKeown or Ivor-Lewis procedure); 6. No surgical contraindications, with cardiac, pulmonary, hepatic, and renal functions sufficient to tolerate surgery; 7. ECOG performance status score of 0 to 1; 8. Written informed consent signed by the patient or legal representative. Exclusion Criteria 1. Preoperative imaging clearly indicating lymph node metastasis (cN+) or distant metastasis (cM1); 2. Prior systemic or local treatment for esophageal cancer of any kind (including chemotherapy, radiotherapy, chemoradiotherapy, immunotherapy, etc.); 3. Previous history of esophageal or gastric surgery (except endoscopic mucosal resection/submucosal dissection); 4. History of allergy to iodine contrast agents or indocyanine green; 5. Severe hepatic or renal insufficiency (Child-Pugh class B or C; serum creatinine ≥ 1.5 times the upper limit of normal); 6. Uncontrolled hyperthyroidism; 7. Concomitant other malignancies requiring simultaneous treatment; 8. Pregnant or lactating women; 9. Other conditions deemed unsuitable for enrollment by the investigator. Withdrawal Criteria 1. Intraoperative exploration revealing inability to achieve radical resection (R2 resection) or extensive thoracic and abdominal metastasis; 2. Intraoperative exploration revealing definite lymph node metastasis (cN+) inconsistent with preoperative staging; 3. Severe allergic reaction after ICG injection requiring discontinuation of the study; 4. Intraoperative change of surgical plan due to severe complications; 5. Withdrawal of informed consent by the patient.