Original communicationIntraoperative lymphatic mapping and sentinel lymph node biopsy using radioactive tracer in gastric cancer
Section snippets
Methods
A total of 32 (6 female) patients who underwent gastrectomy with extended lymphadenectomy, including the sampling of paraaortic lymph nodes, at the Department of Surgery, Ankara Numune Teaching and Research Hospital, Ankara, Turkey, from April 1999 to March 2003 were enrolled in this study.
Results
The 32 gastric cancer patients with a median age of 58 years (range, 34-69 years) were included. The clinicopathologic characteristics of patients enrolled in the study are summarized in Table I. There were no unexpected toxicities or complications related to administration of radioactive tracer.
The operations were uneventful in all patients. There was no intraoperative or in-hospital death. Six patients had some minor complications including prolonged abdominal drainage, delayed gastric
Discussion
The rationale for extended lymph node dissection is that it may achieve an R0 resection attributed to clearance of the metastatic lymph nodes and better locoregional tumor control, which should improve patient survival.25, 26, 27 However, the efficacy of lymph node dissection in gastric cancer is still controversial, and is debated between Western groups and Japanese groups. Several Japanese studies25, 28, 29, 30 reported favorable results with extended lymphadenectomy with positive nodes:total
Conclusion
SLN biopsy using a gamma probe in gastric cancer is a feasible procedure with high sensitivity and accuracy. We believe that SLN biopsy can identify lymph node involvement without adding substantially to the time, cost, or morbidity of the primary surgical procedure. This technique may be of benefit to surgeons in planning the extent of lymph node dissection in gastric cancer.
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