[Limited surgery for early gastric cancer using lymphatic basin dissection--a sure method of sentinel node biopsy for gastric cancer].
The results of our sentinel node biopsy for early-stage gastric cancer had a high predictive value for nodal metastasis, with a sensitivity of 85% (34/40) and an accuracy of 98% (259/265). Therefore, sentinel node biopsy is expected to be decided as an adaptation of limited surgery for early gastric cancer. However, there were two serious problems in sentinel node biopsy for gastric cancer; one was the great difficulty of sentinel node detection and biopsy in the operative field, and the other was the possibility of false negative cases in the frozen section diagnosis. To solve these problems, we developed lymphatic basin dissection, a new technique suitable for sentinel node biopsy of gastric cancer. The lymphatic basin is an own lymphatic components dyed in blue in the dye method. In the lymphatic basin dissection method, sentinel nodes are detected and harvested at the back table after en bloc dissection of the lymphatic basins. Lymphatic basin dissection is an excellent method because of the certainty in sentinel node biopsy, and the sure back-up dissection. Lymphatic basin dissection and following limited surgery was performed on 143 patients for early-stage gastric cancer in our hospital. No patient had a recurrence of gastric cancer; 9 patients died of other diseases, and the other 134 survived.
Kinami
Shinichi
S
Dept. of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medicine, Kanazawa University, Japan.
Miwa
Koichi
K
Ishii
Kaname
K
Miyashita
Tomoharu
T
Fushida
Sachio
S
Fujimura
Takashi
T
Ohta
Tetsuo
T
D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology; D021701:Sentinel Lymph Node Biopsy; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate