[The lymphatics of the esophagus--evaluation of endoscopic RI-lymphoscintigraphy with SPECT].

For the studies of the esophageal lymphatics, endoscopic RI-lymphoscintigraphy was performed in 23 cases of esophageal cancer, 3 cases of lung cancer and 5 cases of gastric cancer. 99mTc-Rhenium colloid was endoscopically injected into the submucosal layer of the esophagus near the tumor and the images of the lymph flow were obtained after about 3 hours. Single photon emission computerized tomography (SPECT) was used to acquire the three-dimensional images of the esophageal lymph flow on 19 patients. RI-uptake of all dissected lymph nodes was also counted after the operation. The results were shown as follows. 1. Whole neck, thoracic and abdominal lymph nodes could be imaged in any cases injected at any parts of the thoracic esophagus. But the lymph flow in the upper third of the esophagus tended to move mainly upward, and the lymph flow in the lower third tended to move mainly downward. 2. The block of intra-mural lymph vessels by the tumor had very important roles upon the esophageal lymph flow. 3. The removal of upper mediastinal lymph nodes and intraabdominal lymph nodes as well as paraesophageal lymph nodes seemed to be very important for curative resection of carcinoma of the esophagus.