Validity of modified gastrectomy combined with sentinel node navigation surgery for early gastric cancer

Ohdaira, Hironori; Nimura, Hiroshi; Mitsumori, Norio; Takahashi, Naoto; Kashiwagi, Hideyuki; Yanaga, Katsuhiko

doi:10.1007/s10120-007-0419-6

Cited by 52 publications

(47 citation statements)

References 16 publications

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“…There have been initiatives that use SLNB in humans for gastric cancer aimed to indicating more economic lymphadenectomies and gastric resections 15,18,19,24,25 , and this conduct is currently becoming accepted in global clinical practice 9,11,26 , especially after the recommendation of the Japanese multicenter trial on the use of SLNB in early gastric cancer (T1 or T2, N0, M0) 27 .…”

Section: Discussionmentioning

confidence: 99%

“…In the last decade, SLNB has also been carried out for cases of early gastric cancer 5,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] .…”

Section: Introductionmentioning

confidence: 99%

“…The initiatives to perform SLNB in early gastric cancer are justified by the less invasive procedures (smaller gastrectomies and the use of videolaparoscopic access), less extensive lymphadenecomies (D1), with consequent preservation of gastric function, better esthetic appearance, less morbidity and mortality, and better quality of life after surgery, without jeopardizing the oncological safety of the treatment and survival of these patients 19,24,28 .…”

Section: Introductionmentioning

confidence: 99%

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Animal model for training in sentinel lymph node biopsy of the stomach through combined methods

Alves¹,

Lopes

Meirelles³

et al. 2012

Acta Cir. Bras.

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PURPOSE:Create and validate a proposed animal model for training in sentinel lymph node biopsy of the stomach. METHODS: In thirty-two rabbits, through a laparotomy, they received a subserosal injection of 0.1 ml of phytate labeled with technetium-99m (0.2 mCi) in the anterior wall of the gastric corpus, followed by 0.2 ml of Blue Patent V ® 2.5%, through the same puncture site. Suspicious lymph nodes were searched in vivo at five, ten and 20 minutes, both visually (Blue Patent stained lymph nodes) and with a manual gamma radiation detector (to detect suspected radioactive lymph nodes). After 20 minutes, was performed resection of these for further evaluation of radioactivity (ex vivo) and histological study. RESULTS: Lymph nodes were identified in 30 rabbits (Average of 2.2 lymph nodes per animal). Of the 90 suspected lymph nodes that occurred in the study, 70 cases (77.8%) were histologically confirmed for lymphoid tissue. Of these, the majority were located in the periesophageal region of the gastric fundus. The sample presented a mortality rate of 6.25% and nine complications related to the method, which interfered in the identification of the lymph nodes. CONCLUSION: The animal model for sentinel node biopsy in rabbit stomachs proved to be feasible, with low complexity and reproduced the difficulties encountered for gastric lymph node biopsy in humans, being adequate for surgical training. Key words: Models, Animal. Sentinel Lymph Node Biopsy. Stomach. Coloring Agents. Technetium. Rabbits. RESUMO OBJETIVO:Criar e validar uma proposta de modelo animal para o treinamento em pesquisa de linfonodos sentinelas no estômago. MÉTODOS: Em trinta e dois coelhos, mediante laparotomia, foi injetado na subserosa da parede anterior do corpo gástrico, 0,1 ml de fitato marcado com tecnécio-99m (0,2 mCi), seguido pelo mesmo orifício, de 0,2 ml de Azul Patente V ® 2,5%. A cavidade abdominal foi avaliada, in vivo, por meio de inspeção para pesquisa de suspeitas de linfonodos azuis e com detector manual de radiação gamma aos cinco, dez e 20 minutos para pesquisa de suspeitas de linfonodos radioativas. Após 20 minutos, foi realizada a ressecção dessas para posterior avaliação da radioactividade (ex vivo) e estudo histológico. RESULTADOS: Foram identificados linfonodos em 30 coelhos (Média de 2,2 linfonodos por animal). Das 90 suspeitas de linfonodos ocorridas no estudo, em 70 casos (77,8%) obteve-se confirmação histológica para tecido linfóide. Destas, a maioria estava localizada na região periesofágica do fundo gástrico. A amostra apresentou taxa de mortalidade de 6,25% e nove intercorrências relacionadas ao método, que interferiram na identificação dos linfonodos. CONCLUSÃO: O modelo animal para pesquisa de linfonodos sentinelas em estômago de coelhos mostrou-se factível, pouco complexo e reproduziu as dificuldades encontradas para a pesquisa de linfonodos gástricos em humanos, sendo adequado para o treinamento cirúrgico. Descritores: Modelos Animais. Biópsia de Linfonodo Sentinela. Estômago. Corantes. Tecnécio. Coelh...

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Section: Discussionmentioning

confidence: 99%

“…In the last decade, SLNB has also been carried out for cases of early gastric cancer 5,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] .…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Animal model for training in sentinel lymph node biopsy of the stomach through combined methods

Alves¹,

Lopes

Meirelles³

et al. 2012

Acta Cir. Bras.

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“…Esta linfadenectomia extensa (D2) é ainda hoje defendida com vigor por vários autores e caracteriza-se como padrão-ouro no tratamento cirúrgico no CaG com perspectiva de cura 9,14 . Porém, tal definição pode estar mudando especialmente nos tumores na fase inicial EC T1/T2 11,27,33 .…”

Section: Linfonodo Sentinela -Histórico E Manuseiounclassified

“…A literatura mostra inúmeros trabalhos principalmente provenientes do Japão que já validam a gastrectomia modificada com linfadenectomia seletiva para o CaG em fase inicial EC T1/T2 19,20,33 .…”

Section: Linfonodo Sentinela -Histórico E Manuseiounclassified

Linfonodo sentinela: importância na cirurgia do câncer gástrico e perspectiva da aplicação de um modelo experimental em caninos

Melo

Pinheiro

2010

ABCD, arq. bras. cir. dig.

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DESCRITORES -Câncer gástrico. Metástase linfática. Biópsia de linfonodo sentinela.RESUMO -Introdução -A única perspectiva de cura do câncer gástrico ainda é o tratamento cirúrgico -gastrectomia associada com linfadenectomia ampliada -, embora tal procedimento possa levar a alto índice de morbidade ou mortalidade. Atualmente, a pesquisa do linfonodo sentinela para o câncer gástrico inicial (EC T1/ T2) apresenta argumentos que podem está modificando esta conduta. Objetivo -Realizar revisão bibliográfica atualizada da importância do linfonodo sentinela na cirurgia do câncer gástrico e apresentar modelo experimental, em caninos, que poderia se prestar como treinamento de cirurgiões para o método da pesquisa de linfonodo sentinela em estômago. Método -Revisão da literatura baseaa no Pubmed/Medline, Scielo e Lilacs cruzando os unitermos câncer gástrico, metástase linfática e biópsia de linfonodo sentinela e apresentação de método experimental para localização de nódulo sentinela. Conclusões -As evidências demonstram que há muito para se comprovar, entretanto a definição do tratamento do CaG nos tumores T1 parece ser o maior foco e abre bastante espaço para pesquisa. O modelo experimental em caninos para a pesquisa do LS no estômago, poderia se prestar como treinamento para cirurgiões na aplicação do método.ABSTRACT -Introduction -The only possibility to cure gastric cancer is still through a surgical treatment -gastrectomy associated with extended lymphadenectomy -, although this procedure may lead to high rates of morbidity or mortality. Currently, sentinel lymph node biopsy for early gastric cancer (T1/T2 EC) presents arguments that can change this behavior. Aim -To review updated bibliography of the importance of sentinel lymph nodes in gastric cancer surgery and present experimental model in dogs, which could provide training for surgeons as to the method of sentinel lymph node in the stomach. Method -Review of literature basing on Pubmed / Medline, Lilacs and Scielo crossing the key-words gastric cancer, lymph node metastasis and sentinel lymph node biopsy and presenting an experimental method for localization of sentinel node. Conclusions -The evidence shows that there is much to prove, however, the definition of the treatment of gastric cancer in T1 tumors appears to be the major focus and opens up plenty of space for research. The experimental model in dogs for the study of LS in the stomach, could provide training for surgeons in the method. ABCDDV/727INTRODUÇÃO O câncer gástrico (CaG) é atualmente a quarta neoplasia maligna mais frequente e a segunda causa de morte entre todos os tipos de câncer no mundo. Sua maior incidência é no Japão, onde se encontram 780 casos por 100.000 habitantes. No Brasil, por 100.000 habitantes, existem de 10 a 20 casos na população masculina e de cinco a 10 casos na população feminina 21 .A gastrectomia (total ou parcial) associada com linfadenectomia é a principal alternativa terapêutica e representa, atualmente, a única perspectiva de cura da doença. Disseminações por contigui...

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Current trends and emerging future of indocyanine green usage in surgery and oncology

Połom

Murawa

Rho

et al. 2011

Cancer

231

172

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Ever since Kitai first performed fluorescent navigation of sentinel lymph nodes (SLNs) using indocyanine green (ICG) dye with a charge-couple device and light emitting diodes, the intraoperative use of near infrared fluorescence has served a critical role in increasing our understanding in various fields of surgical oncology. Here the authors review the emerging role of the ICG fluorophore in the development of our comprehension of the lymphatic system and its use in SLN mapping and biopsy in various cancers. In addition, they introduce the novel role of ICG-guided video angiography as a new intraoperative method of assessing microvascular circulation. The authors attempt to discuss the promising potential in addition to assessing several challenges and limitations in the context of specific surgical procedures and ICG as a whole. PubMed and Medline literature databases were searched for ICG use in clinical surgical settings. Despite ICG's significant impact in various fields of surgical oncology, ICG is still in its nascent stages, and more in-depth studies need to be carried out to fully evaluate its potential and limitations. Cancer 2011;117:4812-22. V C 2011 American Cancer Society.KEYWORDS: sentinel lymph node, indocyanine green, lymphedema, free flaps, axillary reverse mapping, sentinel lymph node biopsy.Near infrared (NIR; emission spectra of $700-850 nm) 1 fluorophores are probes that have gained immense interest in various fields of biomedicine because of their minimal interfering absorption and fluorescence from biological samples, inexpensive laser diode excitation, reduced scattering, and enhanced tissue penetration depth. 2 However, to date, only 1 NIR probe, indocyanine green (ICG) has been approved by the US Food and Drug Administration (FDA); methylene blue is another FDA-approved probe that displays NIR properties, however, it is not considered a pure NIR probe. The former, ICG, is a water-soluble, anionic, amphiphilic tricarbocyanine probe 3 with a hydrodynamic diameter of 1.2 nm, and excitation and emission wavelengths in serum at 778 and 830, respectively. 4,5 For several years, it has been used in ophthalmic angiography 6 and for determining cardiac output 7 and hepatic function. 8 However, it has only recently shown real practicability and feasibility in the field of surgical oncology. Three major domains where NIR-guided ICG fluorophores have appeared most promising are: 1) sentinel lymph node (SLN) detection, 2) evaluation of lymphedema, and 3) assessment of microvascular circulation of free flaps in reconstructive surgery. Although several reviews have discussed the importance of NIR fluorophores (including ICG), 9-13 in this review we limit our discussion specifically to ICG in an attempt to attain a better understanding of its impact and challenges it presents in the field of surgical oncology.Intraoperative SLN Mapping and Biopsy Using ICG The significance of cancer treatment management in relation to first lymphatic drainage from the tumor site, the SLN, was first proposed by Cabanas...

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Validity of modified gastrectomy combined with sentinel node navigation surgery for early gastric cancer

Cited by 52 publications

References 16 publications

Animal model for training in sentinel lymph node biopsy of the stomach through combined methods

Animal model for training in sentinel lymph node biopsy of the stomach through combined methods

Linfonodo sentinela: importância na cirurgia do câncer gástrico e perspectiva da aplicação de um modelo experimental em caninos

Current trends and emerging future of indocyanine green usage in surgery and oncology

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