Gamma-detecting probe used intraoperatively to locate the sentinel lymph node in patients with malignant melanoma.
OBJECTIVE
To assess the usefulness of lymphoscintigraphy and intraoperative gamma probe in the detection of sentinel lymph nodes.


METHODS
Prospective open study.


METHODS
University hospital, Spain.


METHODS
40 patients with malignant melanoma (24 stage I/II, 16 stage III).


METHODS
The day before operation a lymphoscintigram with 99mTc-nanocolloid was taken and the first lymph node identified was considered to be the sentinel node. A hand-held gamma probe was used for intraoperative mapping.


METHODS
Identification of the sentinel node.


RESULTS
Sentinel nodes were identified in 39/40 patients (98%). In 24 patients with stage I/II disease, 34 sentinel nodes were found (6 invaded and 28 clear of melanoma). A total number of 161 regional lymph nodes were harvested, none of them invaded by melanoma. In 16 patients with stage III disease, 22 sentinel nodes were located (14 invaded and 8 clear of melanoma). A total of 89 regional lymph nodes were excised in patients with invaded sentinel nodes (44 of which were invaded and 45 clear of disease). 41 lymph nodes were excised from patients with clear sentinel nodes, and all were also clear of melanoma.


CONCLUSIONS
We conclude that this is a useful technique for the selection of patients with melanoma who may require lymphadenectomy.
Sugrañes
G
G
Department of Surgery, Nuclear Medicine, University of Barcelona, Spain.
Vidal-Sicart
S
S
Piulachs
J
J
Bombuy
E
E
Pons
F
F
Castel
T
T
Rull
R
R
Herranz
R
R
Visa
J
J
D000328:Adult; D000368:Aged; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D007432:Intraoperative Period; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*; D013668:Technetium Tc 99m Aggregated Albumin
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid