Sudan D, Miller S, Mellinger J
Wright State University, Miami Valley Hospital, Dayton, OH 45409.
Surg Endosc. 1993 Mar-Apr;7(2):96-9. doi: 10.1007/BF00704387.
Colorectal malignancies metastasize most frequently to mesenteric lymph nodes. Preoperative staging of these nodes by current modalities is problematic. This study evaluates the feasibility of indirect mesenteric lymphangiography as a colonoscopic technique in a canine model. Ten mongrel dogs underwent endoscopic submucosal injection of Ethiodol at various sites in the transverse, descending, and rectosigmoid areas. Serial abdominal roentgenograms were obtained up to 2 weeks postinjection. In seven of the animals, demonstration of mesenteric nodal uptake corresponding to the area(s) of injection was radiographically documented. In the remaining animals (early in the series) nodal opacification was inadequate. This lack of nodal uptake appeared to be due to nonsubmucosal contrast injection. No complications were noted. Colonoscopic indirect lymphangiography appears to be a safe and potentially useful modality in the evaluation of mesocolonic lymph nodes. Further studies to refine this technique and investigate its potential to preoperatively delineate abnormal nodal architecture are warranted.
结直肠恶性肿瘤最常转移至肠系膜淋巴结。目前通过现有方法对这些淋巴结进行术前分期存在问题。本研究评估了间接肠系膜淋巴管造影作为一种结肠镜技术在犬模型中的可行性。10只杂种犬在横结肠、降结肠和直肠乙状结肠区域的不同部位接受了乙碘油的内镜下黏膜下注射。在注射后长达2周的时间内获取系列腹部X线片。在7只动物中，通过影像学记录显示了与注射区域相对应的肠系膜淋巴结摄取情况。在其余动物（该系列研究早期的动物）中，淋巴结显影不充分。这种淋巴结摄取不足似乎是由于未进行黏膜下造影剂注射所致。未观察到并发症。结肠镜间接淋巴管造影在评估结肠系膜淋巴结方面似乎是一种安全且可能有用的方法。有必要进一步开展研究以完善该技术并研究其术前描绘异常淋巴结结构的潜力。
