[Clinical evaluation of the esophageal lymph flow system based on RI uptake of dissected regional lymph nodes following lymphoscintigraphy].

For surgical treatment of esophageal cancer, the importance of evaluating lymph node metastasis and the lymph flow of the esophagus can not be overemphasized. In oder to investigate the lymph flow of the esophagus, we preoperatively performed lymphoscintigraphy by endoscopic local injection of 99mTc Rhenium Colloid into the esophageal wall in 42 esophageal cancer cases and 4 gastric cancer cases. Postoperatively, the RI uptake of each dissected regional lymph nodes was examined by a Scintillation Counter. The findings were as follows. From the upper third of the thoracic esophagus, the main lymph flow was ascending to the neck and upper mediastinum. From the middle third, the lymph flow was ascending to the neck and upper mediastinum and descending into the abdomen. From the lower third, the main lymph flow was descending to the abdomen. In some cases, the lymph flow to the tracheal bifurcation nodes or to the lymph nodes around the left renal vein was observed. In 61% of the esophageal cancer cases with a partial bilateral neck dissection, the lymph flow to the bilateral supraclavicular lymph nodes was predominant compared to the upper mediastinum nodes.