RT Journal Article
SR Electronic
T1 Lymph node mapping in gastric cancer: a pilot study in Western patients
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP E630
OP E634
DO 10.1503/cjs.019821
VO 65
IS 5
A1 Watanabe, Akie
A1 Hamilton, Trevor D.
YR 2022
UL http://canjsurg.ca/content/65/5/E630.abstract
AB In East Asia, the role of lymph node (LN) mapping in assisting surgical lymphadenectomy, which is integral to the management of gastric cancer, has been explored. We sought to evaluate its safety and utility in Western patients. Thirteen patients with nonmetastatic gastric adenocarcinoma received endoscopic, peritumoural, submucosal indocyanine green fluorescence (ICG) injections before surgery, and ICG was assessed intraoperatively using a laparoscopic detection system. All patients underwent a laparoscopic subtotal gastrectomy, and 10 of them received D2 lymphadenectomies. ICG-mapped LNs fell outside the D1 distribution in all cases, outside the D1+ distribution in 54%, and within the D2 distribution in all cases. There were no ICG-related allergies, procedural complications, or perioperative deaths. We conclude that ICG LN mapping is safe and feasible in assisting LN dissections and localizing the primary tumour in Western patients. D2 dissections should be performed in patients with advanced gastric cancer, as LNs drained outside the D1/D1+ distributions in most cases.