Open AccessSentinel lymph node navigation surgery for early stage gastric cancer
Author(s) -
Norio Mitsumori,
Hiroshi Nimura,
Naoto Takahashi,
Masahiko Kusumoto,
Hiroaki Aoki,
Atsuo Shida,
Nobuo Omura,
Katsuhiko Yanaga
Publication year - 2014
Publication title -
world journal of gastroenterology
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v20.i19.5685
Subject(s) - medicine , sentinel node , sentinel lymph node , indocyanine green , stage (stratigraphy) , cancer , lymph node , biopsy , dissection (medical) , metastasis , lymph , radiology , surgery , pathology , breast cancer , paleontology , biology
We attempted to evaluate the history of sentinel node navigation surgery (SNNS), technical aspects, tracers, and clinical applications of SNNS using Infrared Ray Electronic Endoscopes (IREE) combined with Indocyanine Green (ICG). The sentinel lymph node (SLN) is defined as a first lymph node (LN) which receives cancer cells from a primary tumor. Reports on clinical application of SNNS for gastric cancers started to appear since early 2000s. Two prospective multicenter trials of SNNS for gastric cancer have also been accomplished in Japan. Kitagawa et al reported that the endoscopic dual (dye and radioisotope) tracer method for SN biopsy was confirmed acceptable and effective when applied to the early-stage gastric cancer (EGC). We have previously reported the usefulness of SNNS in gastrointestinal cancer using ICG as a tracer, combined with IREE (Olympus Optical, Tokyo, Japan) to detect SLN. LN metastasis rate of EGC is low. Hence, clinical application of SNNS for EGC might lead us to avoid unnecessary LN dissection, which could preserve the patient's quality of life after operation. The most ideal method of SNNS should allow secure and accurate detection of SLN, and real time observation of lymphatic flow during operation.