title: Sentinel node navigation surgery for gastroduodenal neuroendocrine tumors: Two case reports.
abstract: The percentage of gastroduodenal neuroendocrine tumors (NETs) among all gastroenteropancreatic (GEP) NETs has gradually increased worldwide. Sentinel node navigation surgery (SNNS) has been developed as a personalized approach in the surgical strategy for early gastrointestinal tract cancers. We herein report 2 cases of gastroduodenal NETs treated with SNNS. Technetium-tin colloid including indocyanine green was endoscopically injected into the submucosa around a tumor the day before surgery. Basin dissection including the sentinel nodes (SNs), which were identified by Navigator GPS and near-infrared fluorescence imaging, was performed during laparoscopic surgery. SNs were intraoperatively examined using hematoxylin-eosin (HE) staining.SNs were detected in 2 patients. Lymph node metastasis was intraoperatively identified in 1 of the 2 patients. Consequently, 1 patient with metastatic SNs underwent laparoscopic gastrectomy with lymphadenectomy. Pathological findings identified submucosal NET measuring 6.0 mm × 5.0 mm.Our results suggest that SNNS is a promising surgical tool for detecting subclinical lymph node metastasis in patients with gastroduodenal NETs.
authors.affiliation: aDepartment of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology bMolecular Frontier Surgery, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Arigami
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Uenosono
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Yanagita
authors.forename: Keishi
authors.initials: K
authors.lastname: Okubo
authors.forename: Takashi
authors.initials: T
authors.lastname: Kijima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsushita
authors.forename: Masahiko
authors.initials: M
authors.lastname: Amatatsu
authors.forename: Takahiko
authors.initials: T
authors.lastname: Hagihara
authors.forename: Naoto
authors.initials: N
authors.lastname: Haraguchi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mataki
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Ehi
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: D000368:Aged; D013505:Digestive System Surgical Procedures; D004379:Duodenal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D018358:Neuroendocrine Tumors / Q000556:secondary / Q000601:surgery*; D000071036:Sentinel Lymph Node / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*