Comparative study of the subserosal versus submucosal dye injection method for sentinel node biopsy in gastric cancer.
OBJECTIVE
To determine the most efficient injection method for a sentinel node (SN) biopsy in gastric cancer.


METHODS
Gastric adenocarcinoma patients without serosal invasion and distant metastasis were prospectively enrolled in this study. Isosulfan blue was injected into the subserosa (SS) of the first set of 71 consecutive patients and an intraoperative endoscopic submucosal (SM) injection of the same dye was injected into the second set of 50 consecutive patients. After the biopsy of blue-stained SNs, a gastrectomy with a D2 lymphadenectomy was performed. All dissected lymph nodes were evaluated for metastasis. The results of the SN biopsies were compared between the SS and SM dye injection methods.


RESULTS
Detection rate (0.92 vs 0.94), mean number of SNs (2.5 vs 2.9) and sensitivity (0.61 vs 0.46) of the SN biopsies were not significantly different between the SS and SM injection methods (P>0.05). The operation time was significantly shorter in the SS than the SM injection method (159.7 vs 172.7 min, P=0.030).


CONCLUSIONS
Both injection methods were equally efficient in their roles for a SN biopsy in gastric cancer. However, the SS injection method was more preferable due to its easy technique and short operation time.
Lee
J H
JH
Research Institute and Hospital, National Cancer Center, Gyeonggi, South Korea.
Ryu
K W
KW
Kim
C G
CG
Kim
S K
SK
Choi
I J
IJ
Kim
Y W
YW
Chang
H J
HJ
Bae
J M
JM
Hong
E K
EK
D000230:Adenocarcinoma / Q000473:pathology*; D004396:Coloring Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012394:Rosaniline Dyes / Q000008:administration & dosage*; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013274:Stomach Neoplasms / Q000473:pathology*
D004396:Coloring Agents; D012394:Rosaniline Dyes; C025484:iso-sulfan blue