Methylene blue-assisted lymph node dissection in colon specimens: a prospective, randomized study.
Recently, we introduced ex vivo intra-arterial methylene blue injection into the inferior mesenteric artery as a novel method to improve lymph node (LN) harvest in rectal cancer. We have now adapted this method to the other segments of the colon. A total of 60 cases were enrolled. Primary LN dissection was followed by fat clearance and a secondary dissection. The mean +/- SD primary LN harvest differed highly significantly with 35 +/- 18 and 17 +/- 10 LNs in the methylene blue-stained and unstained groups, respectively. Primary insufficient LN harvest occurred in 8 cases of the unstained group and in only 1 case of the methylene blue-stained group (P = .0226). After secondary dissection, upstaging was seen exclusively in the unstained group. The time/LN ratio differed significantly with 0.9 and 0.6 min/LN in the unstained and methylene blue-stained groups, respectively. Intraarterial methylene blue injection is recommended as a routine technique in the histopathologic study of colon cancer.
Märkl
Bruno
B
Institute of Pathology, Klinikum Augsburg, Augsburg, Germany.
Kerwel
Therese G
TG
Jähnig
Hendrik G
HG
Oruzio
Daniel
D
Arnholdt
Hans M
HM
Schöler
Claus
C
Anthuber
Matthias
M
Spatz
Hanno
H
D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000473:pathology* / Q000601:surgery; D005260:Female; D006651:Histocytochemistry / Q000379:methods; D006801:Humans; D007269:Injections, Intra-Arterial; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D017537:Mesenteric Artery, Inferior; D008751:Methylene Blue; D008875:Middle Aged; D011446:Prospective Studies; D012007:Rectum / Q000473:pathology / Q000601:surgery
D008751:Methylene Blue