[논문]Laparoscopic Assessment of the Sentinel Lymph Node in Early Stage Cervical Cancer

doi:10.1006/gyno.2000.5999

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Abstract Objective. The aim of this study was to describe a minimally invasive technique enabling us to identify the sentinel lymph node in patients affected by early stage cervical cancer and to report the preliminary data. Method. Patent Blue Violet was injected around the tumor. Laparoscopy wa...

Abstract Objective. The aim of this study was to describe a minimally invasive technique enabling us to identify the sentinel lymph node in patients affected by early stage cervical cancer and to report the preliminary data. Method. Patent Blue Violet was injected around the tumor. Laparoscopy was undertaken and the blue-dyed lymph nodes (BDLN) were sought. The evidenced BDLN were removed, and then the systematic dissection was carried out. Material. Thirty-five patients were submitted to surgery. A systematic dissection was performed on 69 pelvic sidewalls (no dissection was performed on the second side of the patient for whom we decided to renounce surgery after assessment of the first side). Results. One or more BDLN was evidenced in 59 of 69 dissections. The rate of failure depends on the quantity of injected blue dye. Failure to identify a BDLN depended on the quantity of injected blue dye: 3 of 6 (50%) for 1.5 ml or less, 3 of 18 (17%) for 2 ml, and only 4 of 45 (10%) after injection of 4 ml (P = 0.05). Among the 63 BDLN (in 4 cases 2 BDLN were identified), 53 were located in contact with the external iliac vein, lateral to the inferior vesical artery, and ventral to the origin of the uterine artery, 7 were located close to the origin of one of the collaterals of the internal iliac artery, and 3 were adjacent to the left common iliac vein. One or more positive pelvic lymph nodes was found in 11 pelvic wall dissections done on 8 patients. The BDLN was the positive node or one of them in all cases. Conclusion. If the sensitivity of the assessment of the BDLN is confirmed to be 100%, this laparoscopic approach could transform the management of early cervical cancer.

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참고문헌 (7)

Bull Johns Hopk Hosp 6 Clark 1896 A more radical method of performing hysterectomy for cancer of the uterus
Urol Clin North Am Cabanas 19 267 1992 10.1016/S0094-0143(21)00389-X Anatomy and biopsy of sentinel lymph nodes

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Ann Surg Oncol Linehan 6 450 1999 10.1007/s10434-999-0450-4 Intradermal radiocolloid and intraparenchymal blue dye injection optimize sentinel node identification in breast cancer patients

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Lancet Veronesi 349 1864 1997 10.1016/S0140-6736(97)01004-0 Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes

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Obstet Gynecol Levenback 84 163 1994 Intraoperative lymphatic mapping for vulvar cancer

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Gynecol Oncol O'Boyle 74 322 1999 Intraoperative lymphatic mapping with isosulfan blue dye in patients undergoing radical hysterectomy: a pilot study
Rev. Chir. Leveuf 219 1923 Les lymphatiques de l'uterus

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[해외논문] Laparoscopic Assessment of the Sentinel Lymph Node in Early Stage Cervical Cancer

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[해외논문] Laparoscopic Assessment of the Sentinel Lymph Node in Early Stage Cervical Cancer

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