Endoscopic sentinel lymph node biopsy in a porcine model.
OBJECTIVE
The objective of this study was to investigate the feasibility of endoscopic sentinel lymph node biopsy in a porcine model.


METHODS
One hundred microcuries of technetium-labeled sulfa colloid (Tc-SC) was injected into the right and left ventrolateral surfaces of the oral tongue of six adult Yorkshire pigs. A handheld gamma probe was used to locate the region of focal radioactivity on the neck that corresponded to the sentinel lymph node (SLN). Next, 0.25 mL of isosulfan blue dye was injected into the Tc-SC injection sites on the tongue. Endoscopic SLN dissection was then performed using a combination of balloon dissection and CO2 insufflation. The operative time, blood loss, and radioactivity of the SLN were measured for each animal.


RESULTS
The SLN was detected transcutaneously with the gamma probe, and endoscopic SLN excision was successful. Endoscopic visualization and an endoscopic gamma probe confirmed the presence of both isosulfan blue dye and radiopositivity in the SLN in each pig. The procedure lasted 22 to 61 minutes (median duration, 35 minutes). There was no measurable blood loss in any of the animals. Mean radioactivity measured 14,466 counts/second per lymph node.


CONCLUSIONS
Endoscopic SLN biopsy for oral tongue lesions is feasible and warrants further study.
Pitman
Karen T
KT
Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA. kpitman@ent.umsmed.edu
Sisk
Jamie D
JD
D000818:Animals; D004195:Disease Models, Animal; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013552:Swine; D014062:Tongue Neoplasms / Q000473:pathology* / Q000601:surgery*