Abstract:
BACKGROUND:In patients with early stage gastric cancer in the middle third of the stomach, pylorus-preserving gastrectomy (PPG) can be an option as function-preserving surgery, although its oncologic safety is not definitively defined. This issues may be overcome using the sentinel node (SN) concept. The aim of this study was to investigate the effectiveness of the SN concept in early gastric cancer patients who are candidates for PPG. METHODS:One hundred fifty-six patients with middle-third location of cT1N0 gastric cancer (single lesion, <4 cm) underwent distal gastrectomy with SN mapping. As a tracer, technetium-99 tin colloid solution and blue dye were endoscopically injected into the submucosal layer surrounding the primary tumor. RESULTS:SN detection rate was 100 % (156 of 156), and the accuracy of the nodal evaluation of metastasis was 99 % (155 of 156). Suprapyloric lymph node (LN; LN No. 5) and infrapyloric LN (LN No. 6) were detected as SNs in 6 and 14 % of the patients, respectively. We also found two cases with metastasis to LN No. 5 or LN No. 6. DISCUSSION:When performing PPG, the possibility of LN metastasis, especially to LN No. 5 and LN No. 6, cannot be underestimated. SN mapping can play an important role to predict the possibility of metastasis to LN No. 5 and LN No. 6.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Shimada A,Takeuchi H,Ono T,Kamiya S,Fukuda K,Nakamura R,Takahashi T,Wada N,Kawakubo H,Saikawa Y,Omori T,Nakahara T,Jinzaki M,Murakami K,Kitagawa Ydoi
10.1245/s10434-016-5358-1subject
Has Abstractpub_date
2016-12-01 00:00:00pages
4247-4252issue
13eissn
1068-9265issn
1534-4681pii
10.1245/s10434-016-5358-1journal_volume
23pub_type
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