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Increased post‐operative complications with methylene blue versus lymphazurin in sentinel lymph node biopsies for skin cancers
Author(s) -
Neves Rogerio I.,
Reynolds Brandon Q.,
Hazard Sprague W.,
Saunders Brian,
Mackay Donald R.
Publication year - 2010
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21845
Subject(s) - medicine , sentinel lymph node , methylene blue , biopsy , lymph , melanoma , surgery , complication , sentinel node , lymph node , radiology , cancer , pathology , breast cancer , biochemistry , chemistry , photocatalysis , cancer research , catalysis
Background Sentinel lymph node biopsy (SNLB) is the standard of care in staging of melanoma and other skin cancers. Early studies used lymphazurin (LZ) for SLNB. A national shortage of LZ promoted methylene blue (MB) as an alternate stain. Objective This study compares complication rates between LZ and MB in SLNB patients, and the reliability dyes in locating sentinel lymph nodes. Methods Charts were reviewed for patients who underwent SLNB for skin cancers between September 2006 and November 2008 at Penn State Hershey Medical Center. The type and quantity of dye, the presence of blue stained sentinel nodes, and any complications were recorded. Results Ninety‐three patients underwent SLNB (46 LZ, 47 MB). The amount of dye used was similar (avg. 0.93 ml LZ, 1.24 ml MB). The complication rate of LZ was 8.7%, and MB was 25.5%. There was significantly more ( P = 0.003) skin graft complications in the MB patients (6/12) versus LZ (0/15). Conclusions There is a higher rate of complications with MB, especially with skin grafting. The reported risk of anaphylaxis with LZ has not been reported in volumes <2 ml. The sentinel lymph node identification rate is historically similar between dyes, and in this study was noted to be higher with LZ. J. Surg. Oncol. 2011; 103:421–425. © 2010 Wiley‐Liss, Inc.