Open AccessSentinel node navigation surgery for gastroduodenal neuroendocrine tumors
Author(s) -
Takaaki Arigami,
Yoshikazu Uenosono,
Shigehiro Yanagita,
Kan Okubo,
Takashi Kijima,
Daisuke Matsushita,
Masahiko Aoki,
Takahiko Hagihara,
Naoto Haraguchi,
Yuko Mataki,
Katsuhiko Ehi,
Sumiya Ishigami,
Shoji Natsugoe
Publication year - 2016
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000004063
Subject(s) - medicine , sentinel node , indocyanine green , lymph node , metastasis , lymphadenectomy , neuroendocrine tumors , gastrectomy , h&e stain , submucosa , sentinel lymph node , laparoscopic surgery , dissection (medical) , radiology , laparoscopy , surgery , pathology , cancer , breast cancer , immunohistochemistry
The percentage of gastroduodenal neuroendocrine tumors (NETs) among all gastroenteropancreatic (GEP) NETs has gradually increased worldwide. Sentinel node navigation surgery (SNNS) has been developed as a personalized approach in the surgical strategy for early gastrointestinal tract cancers. We herein report 2 cases of gastroduodenal NETs treated with SNNS. 99m Technetium-tin colloid including indocyanine green was endoscopically injected into the submucosa around a tumor the day before surgery. Basin dissection including the sentinel nodes (SNs), which were identified by Navigator GPS and near-infrared fluorescence imaging, was performed during laparoscopic surgery. SNs were intraoperatively examined using hematoxylin–eosin (HE) staining. SNs were detected in 2 patients. Lymph node metastasis was intraoperatively identified in 1 of the 2 patients. Consequently, 1 patient with metastatic SNs underwent laparoscopic gastrectomy with lymphadenectomy. Pathological findings identified submucosal NET measuring 6.0 mm × 5.0 mm. Our results suggest that SNNS is a promising surgical tool for detecting subclinical lymph node metastasis in patients with gastroduodenal NETs.