结直肠癌手术中的体腔内淋巴结绘图。
Intracorporeal lymph node mapping in colon cancer surgery.
机构信息
Wellcome EPSRC Centre for Interventional and Surgical Sciences (WEISS), UK; Division of Surgery and Interventional Sciences, University College London, UK.
Wellcome EPSRC Centre for Interventional and Surgical Sciences (WEISS), UK.
出版信息
Eur J Surg Oncol. 2019 Dec;45(12):2316-2318. doi: 10.1016/j.ejso.2019.07.013. Epub 2019 Jul 16.
INTRODUCTION
The 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.
METHODS
A 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.
RESULTS
a video demonstration of the technique and preliminary results in 6 patients is presented in this short report.
CONCLUSION
intracorporeal lymph node mapping is feasible and safe. Further studies are required to determine the place of this technique in modern oncologic colon surgery.
简介
结肠癌淋巴结清扫的最佳方法仍不清楚。争议的焦点集中在不同的标准化“一刀切”淋巴结采集技术的选择上。另一种方法是根据患者的淋巴引流模式来调整淋巴结清扫的范围。
方法
提出了一种个体化淋巴结定位的技术，可以在术中指导外科医生。该技术包括在结肠肿瘤周围的 4 个部位腔内注射 10mg 吲哚菁绿。在标本移动但未取出之前，使用近红外摄像机评估荧光，以便根据患者自身的淋巴引流进行淋巴结清扫。
结果
本研究报告了该技术的视频演示和 6 例患者的初步结果。
结论
腔内淋巴结定位是可行和安全的。需要进一步的研究来确定该技术在现代肿瘤学结肠手术中的地位。
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