Preoperative chemoradiotherapy reduces the lymph node yield in rectal cancer. The number of retrieved lymph nodes is affected by degree of histopathologic response of the tumor to chemoradiation. Thus, number of lymph nodes should not be used as a surrogate for oncologic adequacy of resection after neoadjuvant chemoradiotherapy for rectal cancer.
ABSTRACT.Purpose: To evaluate the potential of brilliant blue G (BBG) for intraoperative staining of the inner limiting membrane (ILM) with respect to staining properties and surgical outcome. Methods: In a retrospective, non-comparative clinical case series, we analysed 17 consecutive chromovitrectomy interventions for surgery of macular holes, ERMs, vitreoretinal traction syndromes and cystoid macular oedema. Following complete posterior vitreous detachment, BBG was injected into the vitreous cavity at a concentration of 0.25 mg ⁄ ml, followed by immediate washout. Main outcome measures were staining properties, visual acuity, central visual field testing and optical coherence tomography (OCT) measurements over a mean follow-up period of 3 months. Results: ILM staining was somewhat less intensive for BBG than for average indocyanine green (ICG) chromovitrectomy. However, the ILM was removed successfully without additional ICG in 15 ⁄ 17 patients. Postoperative visual acuity was improved in 16 ⁄ 17 patients and remained unchanged in one patient. Central retinal OCT thickness showed a postoperative reduction, with values ranging from +7 to )295 lm (median )89 lm). Neither visual field defects nor any other adverse events were recorded. Conclusion: BBG permits sufficient staining for safe ILM removal. In this short-term study, good anatomical and functional results were achieved and no adverse events were observed.
As an adjunct to chromovitrectomy to stain the ILM, BBG yields a significantly less well discernible contrast to the human eye than that of ICG under the premises of this study.
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