[New method of lymph node tracing in gastrectomy for advanced gastric carcinoma].
OBJECTIVE
To develop a new method of lymph node tracing in gastrectomy for advanced gastric carcinoma (AGC).


METHODS
Forty-six patients with gastric angle carcinoma with metastasis in the third group lymph nodes underwent radical operation. During the operation methylene blue was injected inside or around the border of the metastatic third group lymph nodes. The secondary sentinel lymph nodes (SSLNs) that were the nearest to the third group lymph nodes were searched in 5 approximately 10 minutes, and the SSLNs discovered were resected to undergo HE staining and immunohistochemistry.


RESULTS
SSLNs were found in 38 patients with a positive rate of 82.6% by methylene blue staining. Pathological examination found SSLNs in 30 cases with a positive rate of 78.9%. Totally 68 SSLNs were found in the 38 patients. The numbers of methylene blue positive SSLN in the groups 7, 5, 4, 6, 9, and 8 were 40, 9, 7, 5, 4, and 3 respectively. Pathology and histochemistry found 31, 9, 5, 4, 2, and 1 SSLNs in the groups 7, 5, 4, 6, 9, and 8 with the positive rates of 77.5%, 100%, 71.4%, 80.0%, 50.0%, and 33.3% respectively. There were no significant correlation between the size and degree of differentiation of tumor and the positive rate of SSLN.


CONCLUSIONS
The technique of SSLN tracing expands the application range of SLN tracing and provides a new thinking for study of lymph node in gastric carcinoma in different stages.
Jiang
Huai-wu
HW
Department of Surgery, The Second Affiliated Hospital of North Sichuan Medical College, Mianyang 621000, China.
Jian
Xun
X
Xiao
Shi-ming
SM
Chen
Jin
J
Tao
Ya
Y
D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007267:Injections; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008751:Methylene Blue / Q000008:administration & dosage; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery
D008751:Methylene Blue