Laparoscopic Sentinel Lymph Node Identification in Patients with Colon Carcinoma Using a Near-Infrared Dye: Description of a New Technique and Feasibility Study

Abstract

Preliminary results of laparoscopic sentinel node identification using a near-infrared dye show this procedure is safe and feasible. It was possible to detect lymph nodes in all patients. Large tumor size, drainage to adjacent lymphatic vessels, and the use of a rigid needle might contribute to false-negative nodes.

Ex vivo detection of tumoral lymph nodes of colorectal origin with fluorescence imaging after intraoperative intravenous injection of indocyanine green

“…Finally, some studies have reported the use of ICG-FI in the detection of sentinel lymph nodes (SLNs) after peri-tumoral injection to increase staging accuracy in primary colorectal cancer [13,14]. In these studies, as in previous studies using the classical blue dye technique for SLN detection, the SLN represents the first LN draining the tumor and is, therefore, more at risk of harboring tumoral cells.…”

“…All four patients with positive LNs at pathology were negative for fluorescent SLNs [14]. More recently, we have reported the results of a study using ex vivo ICG-FI for SLN detection in colorectal cancer and compared it with the standard blue dye technique.…”

Intraoperative Sentinel Node Mapping in the Colon: Potential and Pitfalls

“…Other studies have shown even lower rates of sensitivity from this approach. Van der Pas et al [29] undertook laparoscopic NIR ICG mapping, but they also added human albumin solution to the ICG to encourage nodal accumulation. Of their 14 patients, 4 had positive nodes, but in those 4 cases the sentinel nodes were falsely negative using both H&E and immunohistochemistry assessment.…”

Comparison of Real-Time Fluorescent Indocyanine Green and 99mTc-Nanocolloid Radiotracer Navigation in Sentinel Lymph Node Biopsy of Penile Cancer

“…Despite the increased use of ICG in the DSNB for breast, 18 colon, 19 melanoma, 20 and other cancers, 21 there have only been 4 studies to our knowledge on the use of ICG in the DSNB for penile cancer.…”