The clinical significance of lateral pelvic sentinel lymph node biopsy using indocyanine green fluorescence navigation in laparoscopic lateral pelvic lymph node dissection
10.3760/cma.j.cn112152-20231026-00265
- VernacularTitle:吲哚菁绿荧光导航的侧方前哨淋巴结活检在腹腔镜直肠癌侧方淋巴结清扫中的临床意义
- Author:
Hao SU
1
;
Zheng XU
;
Mandula BAO
;
Shou LUO
;
Jianwei LIANG
;
Wei PEI
;
Xu GUAN
;
Zheng LIU
;
Zheng JIANG
;
Mingguang ZHANG
;
Zhixun ZHAO
;
Weisen JIN
;
Haitao ZHOU
Author Information
1. 北京大学肿瘤医院暨北京市肿瘤防治研究所，恶性肿瘤发病机制及转化研究教育部重点实验室胃肠肿瘤中心，北京100142
- Keywords:
Rectal neoplasms;
Lateral pelvic lymph node dissection;
Sentinel lymph node;
Indocyanine green fluorescence navigation
- From:
Chinese Journal of Oncology
2024;46(2):140-145
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:This study aims to explore the clinical significance of lateral pelvic sentinel lymph node biopsy (SLNB) using indocyanine green (ICG) fluorescence navigation in laparoscopic lateral pelvic lymph node dissection (LLND) and evaluate the accuracy and feasibility of this technique to predict the status of lateral pelvic lymph nodes (LPLNs).Methods:The clinical and pathological characteristics, surgical outcomes, lymph node findings and perioperative complications of 16 rectal cancer patients who underwent SLNB using ICG fluorescence navigation in laparoscopic LLND in the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College during April 2017 and October 2022 were retrospectively collected and analyzed. The patients did not receive preoperative neoadjuvant radiotherapy and presented with LPLNs but without LPLN enlargement (MRI showed the maximum short axes of the LPLNs were ≥5 mm and <10 mm at first visit).Results:All 16 patients were successfully performed SLNB using ICG fluorescence navigation in laparoscopic LLND. Three patients underwent bilateral LLND and 13 patients underwent unilateral LLND. The lateral pelvic sentinel lymph nodes (SLNs) were clearly fluorescent before dissection in 14 patients and the detection rate of SLNs for these patients was 87.5%. Lateral pelvic SLN metastasis was diagnosed in 2 patients and negative results were found in 12 patients by frozen pathological examinations. Among the 14 patients in whom lateral pelvic SLNs were detected, the dissected lateral pelvic non-SLNs were all negative. All dissected LPLNs were negative in two patients without fluorescent lateral pelvic SLNs. The specificity, sensitivity, negative predictive value, and accuracy was 85.7%, 100%, 100%, and 100%, respectively.Conclusions:This study indicates that lateral pelvic SLNB using ICG fluorescence navigation shows promise as a safe and feasible procedure with good accuracy. This technique may replace preventive LLND for locally advanced lower rectal cancer.
