title: Minor gastric resections with modified lymphadenectomy in early gastric cancer with negative sentinel node.
abstract: OBJECTIVE
  To study the sentinel lymph node in early gastric cancer as a diagnostic method of unsuspected lymph node metastasis, which may allow the performance, in those with negative lymph nodes, of smaller gastric resections with limited lymphadenectomy.
  
  
  METHODS
  We studied seven patients with early gastric cancer treated at the Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, from September 2008 to May 2011, who underwent sentinel lymph node exams, performed by intraoperative peritumoral endoscopic injection of patent blue dye.
  
  
  RESULTS
  We found an average of three sentinel nodes per patient. The frozen biopsy of lymph nodes was negative for metastases, which allowed the realization of atypical gastric resection in three cases and antrectomy with BI reconstruction in four. The performed lymphadenectomy was modified D1. There was no operative mortality. The duration of postoperative follow-up ranged from five to 37 months, without evidence of recurrence. One patient developed a second early tumor 13 months after the initial surgery and underwent total gastrectomy.
  
  
  CONCLUSIONS
  The sentinel lymph node in early gastric cancer proved to be an effective method for the evaluation of nodal metastases in seven patients and allowed for smaller gastric resections and limited lymphadenectomies. These minor procedures reduce the risk of postoperative complications, maintaining, on the other hand, the oncological radicality that is required in the treatment of gastric cancer.
authors: Department of Surgery, Faculty of Medicine, UFRJ, Brazil. guilhermebravo@gmail.com
authors: Guilherme Pinto
authors: GP
authors: Bravo Neto
authors: Elizabeth Gomes
authors: EG
authors: Dos Santos
authors: Carlos André Dos Santos
authors: CA
authors: Loja
authors: Felipe Carvalho
authors: FC
authors: Victer
authors: Marcelo Soares
authors: MS
authors: Neves
authors: Márcia Ferreira
authors: MF
authors: Pinto
authors: Carlos Eduardo de Souza
authors: CE
authors: Carvalho
mesh_terms: D000368:Aged; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*