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Title of Journal: World J Surg

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Abbravation: World Journal of Surgery

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Springer-Verlag

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DOI

10.1007/bf00429617

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1432-2323

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Laparoscopic Lymphatic Mapping and Sentinel Node B

Authors: Hitoshi Tonouchi Yasuhiko Mohri Kouji Tanaka Minako Kobayashi Yukinari Ohmori Masato Kusunoki
Publish Date: 2005/03/22
Volume: 29, Issue: 4, Pages: 418-421
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Abstract

Sentinel node SN biopsies might be useful for performing minimally invasive surgery without interrupting surgical curability This study examined the cause of false negativity during laparoscopic lymphatic mapping and SN biopsies for earlystage gastric cancer Thirtyseven patients with gastric cancer preoperative stage T12 or N0 who underwent laparoscopic lymph node mapping and SN biopsies between March 2001 and June 2004 were enrolled in this study The tracer patent blue and technecium99mlabeled tin colloid was injected endoscopically Bluestained or radioactive nodes were defined as SNs Gastrectomy with lymphadenectomy was performed then the results of the SN biopsies were compared with the final diagnosis of the removed lymph nodes in permanent sections Sentinel nodes were successfully identified in 35 patients 946 and they were positive in 3 of 4 patients with metastatic lymph nodes sensitivity was 75 and specificity was 100 Sentinel node status could therefore be used to diagnose lymph node status with 971 accuracy Of 6 SNs with metastasis 5 showed radioactivity and only 2 were blue stained In the false negative case a radioactive SN with metastasis in the right paracardial region was missed during laparoscopic mapping An error in laparoscopic intracorporeal detection of the radioactive node with metastasis occurred because we could not eliminate the shinethrough effect We found that during laparoscopic SN mapping there is a high risk of false negativity with SNs located in the right paracardial region To apply laparoscopic SN mapping to earlystage gastric cancer patients the shinethrough effect must be eliminated because radiotracers are essential for this methodWith this manuscript the World Journal of Surgery begins a new chapter a video methods section Surgical techniques are often best understood when shown in action Not only have Tonouchi and associates told us how to perform laparoscopic sentinel node dissection for gastric cancer they show us how to perform this procedure in a oneminute 20second video in the World Journal of Surgery online publication at http//wwwspringerlinkcom

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  13. An Observational Trial for Papillary Thyroid Microcarcinoma in Japanese Patients
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