Laparoscopic sentinel node navigation achieved by infrared ray electronic endoscopy system in patients with gastric cancer
Laparoscopic sentinel node navigation achieved by infrared ray electronic endoscopy system in patients with gastric cancer
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DOI：
10.1007/s00464-006-9062-2
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发表时间：
2007-07-01
影响因子：
3.1
通讯作者：
Kitano, S.
中科院分区：
文献类型：
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作者：
Ishikawa, K.;Yasuda, K.;Kitano, S.
背景：前哨淋巴结（SN）概念近期在早期胃癌（EGC）患者的治疗中备受关注。本研究评估了在早期胃癌患者中通过注射吲哚菁绿（ICG）并利用红外线电子内镜（IREE）系统实现腹腔镜前哨淋巴结导航的可行性。
方法：对16例术前诊断为早期胃癌的患者进行腹腔镜前哨淋巴结导航。确定前哨淋巴结后，进行常规腹腔镜辅助远端胃切除术及淋巴结清扫术。对每个淋巴结的一个切片用苏木精 - 伊红染色进行组织学检查以确定是否有转移。
结果：16例患者均检测到一个或多个前哨淋巴结及淋巴流域。检测到的前哨淋巴结平均数量为2.9个。16例患者中有2例（13%）发现淋巴结转移。在这2例患者中，其中1例在前哨淋巴结中发现淋巴结转移，另1例在非前哨淋巴结而非前哨淋巴结中发现转移，但在同一淋巴流域。这种检测方法的准确率为94%，有1例假阴性病例。注射ICG后未发生不良事件。
结论：对于接受腹腔镜手术治疗的早期胃癌患者，通过IREE结合ICG注射进行腹腔镜前哨淋巴结导航是可行的。
Background: The sentinel node (SN) concept has attracted considerable attention recently for the treatment of patients with early gastric cancer (EGC). This study evaluated the feasibility of laparoscopic SN navigation achieved by means of an infrared ray electronic endoscopy (IREE) system with indocyanine green (ICG) injection in patients with EGC.Methods: Laparoscopic SN navigation was performed for 16 patients with preoperatively diagnosed EGC. After identification of SNs, routine laparoscopically assisted distal gastrectomy with lymphadenectomy was performed. Lymph nodes were examined histologically for metastasis by hematoxylin and eosin staining on one section of each node.Results: One or more SNs and lymphatic basins were detected in all 16 patients. The average number of SNs detected was 2.9. Lymph node metastasis was found in 2 of the 16 patients (13%). In one of these two patients, lymph node metastasis was found in SNs. In the other patient, metastasis was found in a non-SN rather than a SN, but in the same lymphatic basin. The accuracy of this detection method was 94%, and there was one false-negative case. No adverse events occurred after injection of ICG.Conclusion: Laparoscopic SN navigation by means of IREE combined with ICG injection is feasible for patients undergoing laparoscopic Surgery for EGC.