Intraoperative sentinel lymph node mapping in patients with colorectal cancer.
OBJECTIVE
In about 1/3 of the patients with colorectal cancer without metastases which have been radically operated recurrences are observed and these patients die from cancer. This requires improvement of the surgical methods radicality as well as a more accurate determination of the indications for adjuvant chemotherapy administration. The introduction of a method for evaluating the degree of the metastases in colorectal cancer would highlight these issues. To this purpose we apply the method of sentinel mapping.


METHODS
For a period of one year we performed intraoperative sentinel mapping on 103 patients who had been operated for colon or rectal cancer. We used the dying method with Patent Blue V. An algorithm was worked out for sentinel mapping in colorectal cancer.


RESULTS
We achieved 100% performance success and 97% sensitivity. We increased the volume of the surgical intervention in 100% of the patients and elevated the clinical stage of 20% of the patients in Ist and IInd stage by means of ultrastaging with immunohistochemistry.


CONCLUSIONS
We conclude that sentinel lymph nodes mapping in colorectal cancer is a diagnostic method which is convenient for the surgeons allowing them for an individualized approach toward each patient.
Ivanov
K
K
Clinic of General and Operative Surgery, University Hospital "St. Marina", Varna, Bulgaria. kivanov@gisurgery.bg
Kolev
N
N
Ignatov
V
V
Madjov
R
R
D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D004396:Coloring Agents; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012394:Rosaniline Dyes; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
D004396:Coloring Agents; D012394:Rosaniline Dyes; C008769:sulfan blue