Department of Obstetrics and Gynecology, Ankara University School of Medicine, Ankara, Turkey.
Department of Obstetrics and Gynecology, Ankara University School of Medicine, Ankara, Turkey.
Int J Surg. 2017 Nov;47:13-17. doi: 10.1016/j.ijsu.2017.09.015. Epub 2017 Sep 14.
To evaluate feasibility of sentinel lymph node (SLN) mapping by using near-infrared fluorescent imaging and indocyanine green (NIR/ICG) integrated laparoscopic system in clinically uterine-confined endometrial cancer.
Patients with clinically early-stage endometrial cancer were included in this prospective study. ICG was injected to the uterine cervix and NIR/ICG integrated laparoscopic system (Spies Full HD D-Light P ICG technology, Karl Storz, Tuttlingen, Germany) was used during the operations. SLN and/or suspicious lymph nodes were resected. Side specific lymphadenectomy was performed when mapping was unsuccessful. Systematic lymphadenectomy was completed following SLN algorithm steps.
Seventy-one eligible patients were analyzed. The overall, unilateral and bilateral SLN detection rates were 95.7%, 18.3%, 77.4%, respectively. There were 8 (11.2%) patients with lymph node metastasis. One of them was isolated para-aortic node metastasis. Negative predictive value, sensitivity and false negative rate for detecting lymphatic spread were 98.4%, 87.5% and 1.5%, respectively.
Sentinel lymph node mapping can easily be performed with high accuracy by using NIR/ICG integrated conventional laparoscopic system in endometrial cancer and almost all lymphatic spread can be detected.
评估近红外荧光成像和吲哚菁绿（NIR/ICG）联合腹腔镜系统在临床局限型子宫内膜癌中进行前哨淋巴结（SLN）检测的可行性。
本前瞻性研究纳入了临床早期子宫内膜癌患者。在手术过程中，将 ICG 注射到子宫颈，并使用 NIR/ICG 联合腹腔镜系统（Spies Full HD D-Light P ICG 技术，Karl Storz，德国图特林根）。切除 SLN 和/或可疑淋巴结。如果 SLN 检测不成功，则进行侧方特异性淋巴结切除术。完成 SLN 算法步骤后，进行系统淋巴结切除术。
共分析了 71 例符合条件的患者。总的、单侧和双侧 SLN 检测率分别为 95.7%、18.3%和 77.4%。8 例（11.2%）患者发生淋巴结转移。其中 1 例为孤立性腹主动脉旁淋巴结转移。检测淋巴转移的阴性预测值、敏感度和假阴性率分别为 98.4%、87.5%和 1.5%。
在子宫内膜癌中，使用 NIR/ICG 联合常规腹腔镜系统可轻松、准确地进行 SLN 检测，几乎可以检测到所有的淋巴转移。
