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Sentinel Node Mapping Using a Fluorescent Dye and Visible Light During Laparoscopic Gastrectomy for Early Gastric Cancer: Result of a Prospective Study From a Single Institute

Lee, Chang Min MD, PhD; Park, Sungsoo MD, PhD; Park, Seong-Heum MD, PhD; Jung, Sung Woo MD, PhD; Choe, Jung Wan MD; Sul, Ji-Young MD, PhD; Jang, You Jin MD, PhD; Mok, Young-Jae MD, PhD; Kim, Jong-Han MD, PhD

Annals of Surgery:
doi: 10.1097/SLA.0000000000001739
Original Articles
Abstract

Objective: The aim of this study was to investigate the feasibility of sentinel node mapping using a fluorescent dye and visible light in patients with gastric cancer.

Background: Recently, fluorescent imaging technology offers improved visibility with the possibility of better sensitivity or accuracy in sentinel node mapping.

Methods: Twenty patients with early gastric cancer, for whom laparoscopic distal gastrectomy with standard lymphadenectomy had been planned, were enrolled in this study. Before lymphadenectomy, the patients received a gastrofiberoscopic peritumoral injection of fluorescein solution. The sentinel basin was investigated via laparoscopic fluorescent imaging under blue light (wavelength of 440–490 nm) emitted from an LED curing light. The detection rate and lymph node status were analyzed in the enrolled patients. In addition, short-term clinical outcomes were also investigated.

Results: No hypersensitivity to the dye was identified in any enrolled patients. Sentinel nodes were detected in 19 of 20 enrolled patients (95.0%), and metastatic lymph nodes were found in 2 patients. The latter lymph nodes belonged to the sentinel basin of each patient. Meanwhile, 1 patient (5.0%) experienced a postoperative complication that was unrelated to sentinel node mapping. No mortality was recorded among enrolled cases.

Conclusions: Sentinel node mapping with visible light fluorescence was a feasible method for visualizing sentinel nodes in patients with early gastric cancer. In addition, this method is advantageous in terms of visualizing the concrete relationship between the sentinel nodes and surrounding structures.

Author Information

*Department of Surgery, Korea University Medical Center, Seoul, South Korea

Department of Surgery, Korea University College of Medicine, Seoul, South Korea

Department of Internal Medicine, Korea University Medical Center, Seoul, South Korea

§Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea

Department of Surgery, Chungnam National University Hospital, Daejeon, South Korea

||Department of Surgery, Chungnam National University School of Medicine, Daejeon, South Korea.

Reprints: Jong-Han Kim, MD, PhD, Department of Gastroenterologic Surgery, Korea University Medical Center Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si 425-707, Gyeonggi-do, South Korea. E-mail: ppongttai@gmail.com.

Disclosure: The authors report no conflicts of interest.

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