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International Journal of Colorectal Disease

Published in:

01-03-2012 | Original Article

Ultrastaging of colon cancer by sentinel node biopsy using fluorescence navigation with indocyanine green

Authors: Christoph Hirche, Zarah Mohr, Sören Kneif, Sergiu Doniga, Dawid Murawa, Martin Strik, Michael Hünerbein

Published in: International Journal of Colorectal Disease | Issue 3/2012

Abstract

Purpose

Lymph node status is the most important prognostic factor in colon cancer, but the role of sentinel lymph node biopsy (SLNB) as a tool for identification of micrometastatic disease and extraanatomical lymph nodes for adjuvant strategies and a tailored approach still remains unclear. Indocyanine green (ICG) fluorescence detection is a new method for SLNB allowing real-time lymphography and lymph node detection. This study was designed to evaluate the feasibility of fluorescence-guided sentinel lymph node detection in colon carcinoma.

Methods

Twenty six patients with colon adenocarcinoma were prospectively included in this study. Intraoperatively, a peritumorous injection with a mean of 2.0 ml ICG was performed, followed by lymphatic mapping and SLNB. Clinical feasibility, detection rate, and sensitivity of the method were analyzed.

Results

No adverse reactions occurred due to the injection of ICG. Overall, ICG fluorescence imaging identified 1.7 sentinel lymph node (SLN) in average in 25 out of 26 patients (detection rate, 96%). Metastatic involvement of the SLN was found in nine out of 11 nodal positive patients by conventional histopathology. The sensitivity of the method was 82% for colon carcinoma, respectively.

Conclusion

ICG fluorescence imaging is a new, feasible method for SLNB of colon carcinoma and enables ultrastaging with improved accuracy but with limited validity due to the small number of cases. One advantage of this technique is real-time visualization of lymphatic vessels and SLNB without radiation exposure. Further, larger series are necessary to analyze the role of fluorescence-guided SLNB for colon cancer.

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Title: Ultrastaging of colon cancer by sentinel node biopsy using fluorescence navigation with indocyanine green
Authors: Christoph Hirche
Zarah Mohr
Sören Kneif
Sergiu Doniga
Dawid Murawa
Martin Strik
Michael Hünerbein
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 3/2012
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-011-1306-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Ultrastaging of colon cancer by sentinel node biopsy using fluorescence navigation with indocyanine green

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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