Intracorporeal lymph node mapping in colon cancer surgery |
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| Affiliation: | 1. Wellcome EPSRC Centre for Interventional and Surgical Sciences (WEISS), UK;2. Division of Surgery and Interventional Sciences, University College London, UK;1. The Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, 6 Tatton Grove, Manchester, M20 4BU, Greater Manchester, United Kingdom;2. Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health Sciences, University of Manchester, 46 Grafton Street, Manchester, M13 9NT, UK;3. Manchester Cancer Research Centre and NIHR Manchester Biomedical Research Centre, University of Manchester, 29 Grafton Street, Manchester, M13 9WL, UK;1. Department of Surgery, St George Hospital & University of New South Wales, Sydney, New South Wales, Australia;2. College of Medicine, Imam Muhammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia;3. Department of Medical Oncology, St George Hospital & University of New South Wales, Department of Surgery, Sydney, NSW, Australia;4. Cancer Care Centre, St George Hospital, Sydney, NSW, Australia;1. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States;2. Deparmernt of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States;3. Department of Neurosurgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States;4. Department of Neurosurgery, Albert Einstein College of Medicine, New York, NY, United States;1. Colorectal Surgery Unit, Peter MacCallum Cancer Centre, Melbourne, Australia;2. Colorectal Surgery Unit, Christchurch Hospital, Christchurch, New Zealand;1. Belgian Cancer Registry, Rue Royale 215, Koningstraat 215 – 1210, Bruxelles, Brussel, Belgium;2. Belgian Health Care Knowledge Centre (KCE). Centre Administratif Botanique, Doorbuilding, Boulevard du Jardin Botanique 55, B-1000, Brussels, Belgium;3. Department of Respiratory Medicine, University Hospitals KU Leuven, Herestraat 49, 3000, Leuven, Belgium;4. Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp University Hospital, Universiteitsplein 1, 2610, Antwerp, Belgium;5. Department of Pulmonology & Thoracic Oncology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium;6. European Reference Network (ERN-LUNG/EURACAN);7. Department of Thoracic Surgery, University Hospitals KU Leuven, Herestraat 49, 3000, Leuven, Belgium |
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| Abstract: | IntroductionThe best approach to lymphadenectomy in colon cancer is still unknown. The debate has centred around different options of standardised “one size fits all” lymph node harvest techniques. A different approach is tailoring lymph node harvest to the patient's lymphatic drainage pattern.MethodsA technique for individualised lymph node mapping is proposed, which can guide the surgeon intraoperatively. It consists in the intracorporeal injection of 10 mg of indocyanine green at 4 points in the periphery of the colonic tumour. A near infrared camera is used to assess the fluorescence after specimen mobilisation but before extraction, allowing lymphadenectomy based on the patient's own lymphatic drainage.Resultsa video demonstration of the technique and preliminary results in 6 patients is presented in this short report.Conclusionintracorporeal lymph node mapping is feasible and safe. Further studies are required to determine the place of this technique in modern oncologic colon surgery. |
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| Keywords: | Colon cancer Lymph node Mapping Fluorescence |
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