Feasibility of laparoscopic sentinel basin dissection for limited resection in early gastric cancer.
BACKGROUND
The clinical applications of sentinel node (SN) biopsies in early gastric cancer are limited because of low sensitivity. Sentinel basin (SB) dissection has been suggested as alternative to SN biopsy to improve sensitivity. The aim of this study was to examine the feasibility of laparoscopic SB dissection.


METHODS
Twenty-one gastric adenocarcinoma patients of cT1N0 were enrolled. Technetium 99 m human serum albumin and indocyanine green were injected into the submucosal layer around tumor using an intraoperative endoscope. Green-stained or radioactive lymphatic basins were detected and defined as SBs. After laparoscopic SB dissection, laparoscopy-assisted gastrectomy with D2 lymphadenectomy was performed. Dissected SB nodes and non-SB nodes were evaluated for metastasis pathologically.


RESULTS
The SB detection rate was 95.2%. Numbers of SBs were one in 6, two in 10, and three in 4 patients. The mean number of SB nodes was 7.0. Two patients with lymph node metastasis were diagnosed by SB dissection. Mean time of laparoscopic SB dissection procedure was 15.2 min.


CONCLUSIONS
Above findings suggest that laparoscopic SB dissection is technically feasible, and it might have better sensitivity than SN biopsy. However, the validity of this procedure should be evaluated in a larger series before being clinically applied.
Lee
Jun Ho
JH
Gastric Cancer Branch, National Cancer Center, Korea.
Ryu
Keun Won
KW
Kook
Myeong-Cherl
MC
Lee
Jong Yeul
JY
Kim
Chan Gyoo
CG
Choi
Il Ju
IJ
Kim
Seok-Ki
SK
Jang
Seyoun
S
Park
Sook Ryun
SR
Kim
Young Woo
YW
Nam
Byung-Ho
BH
Bae
Jae-Moon
JM
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery