Assessment of the sentinel lymph node (SLN) in patients with early stage breast cancer is vital in selecting the appropriate surgical approach. However, the existing methods, including methylene blue and nuclides, possess low efficiency and effectiveness in mapping SLNs, and to a certain extent exert side effects during application. Indocyanine green (ICG), as a fluorescent dye, has been proved reliable usage in SLN detection by several other groups. In this paper, we introduce a novel surgical navigation system to detect SLN with ICG. This system contains two charge-coupled devices (CCD) to simultaneously capture real-time color and fluorescent video images through two different bands. During surgery, surgeons only need to follow the fluorescence display. In addition, the system saves data automatically during surgery enabling surgeons to find the registration point easily according to image recognition algorithms. To test our system, 5 mice and 10 rabbits were used for the preclinical setting and 22 breast cancer patients were utilized for the clinical evaluation in our experiments. The detection rate was 100% and an average of 2.7 SLNs was found in 22 patients. Our results show that the usage of our surgical navigation system with ICG to detect SLNs in breast cancer patients is technically feasible.
Background:Laparoscopic left lateral hepatic sectionectomy (LLLHS) has been widely accepted because of the benefits of minimally invasive surgery. We aimed to assess the benefits and drawbacks of left lateral sectionectomy (of segments II/III) compared with laparoscopic and open approaches.Methods:Relevant literature was searched using the PubMed, Embase, Cochrane, and Ovid Medline databases. We calculated odds ratios or mean differences with 95% confidence intervals (CIs) for fixed-effects and random-effects models.Results:The meta-analysis included 14 trials involving 685 patients. There were no statistically significant differences between LLLHS and open LLHS (OLLHS) regarding analgesia (P = .31), pedicle clamping (P = .70), operative time (P = .54), hospital expenses (P = .64), postoperative alanine aminotransferase levels (P = .57), resection margin (95% CI –3.02–4.28; P = .73), or tumor recurrence (95% CI 0.51–3.05; P = .62). However, the LLLHS group showed significantly better results regarding blood transfusion (95% CI 0.14–0.73; P = .007), blood loss (95% CI −140.95 to −67.23; P <.001), total morbidity (95% CI 0.24–0.56; P <.01), and hospital stay (95% CI –3.84 to –2.31; P <.001) than the OLLHS group.Conclusion:LLLHS has an advantage in the hospital stay, blood loss, and total morbidity. It is an ideal method for LLHS surgery.
Sentinel lymph node biopsy performed using the nanocarbon staining method is simple, easy and reliable, and it can be used to predict the axillary status of breast cancer in the early stage.
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