Minimally invasive surgery for gastric cancer — toward a confluence of two major streams: a review

Kitagawa, Yuko; Kitano, Seigo; Kubota, Tetsuro; Kumai, Koichiro; Otani, Yoshihide; Saikawa, Yoshiro; Yoshida, Masashi; Kitajima, Masaki

doi:10.1007/s10120-005-0326-7

Cited by 92 publications

(70 citation statements)

References 62 publications

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“…The SLNB in this animal model presented a detection rate and average number of lymph nodes found per animal that were comparable with other studies on humans 5,9,15,20,21 .…”

Section: Discussionsupporting

confidence: 88%

“…Regarding the method chosen in this study, we used combined methods for SLNB 5,9,18,20,21 , through injection of RC and staining in the subserosa of the gastric wall 13,23,26 .…”

Section: Discussionmentioning

confidence: 99%

“…In the last decade, SLNB has also been carried out for cases of early gastric cancer 5,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] .…”

Section: Introductionmentioning

confidence: 99%

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Animal model for training in sentinel lymph node biopsy of the stomach through combined methods

Alves¹,

Lopes

Meirelles³

et al. 2012

Acta Cir. Bras.

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PURPOSE:Create and validate a proposed animal model for training in sentinel lymph node biopsy of the stomach. METHODS: In thirty-two rabbits, through a laparotomy, they received a subserosal injection of 0.1 ml of phytate labeled with technetium-99m (0.2 mCi) in the anterior wall of the gastric corpus, followed by 0.2 ml of Blue Patent V ® 2.5%, through the same puncture site. Suspicious lymph nodes were searched in vivo at five, ten and 20 minutes, both visually (Blue Patent stained lymph nodes) and with a manual gamma radiation detector (to detect suspected radioactive lymph nodes). After 20 minutes, was performed resection of these for further evaluation of radioactivity (ex vivo) and histological study. RESULTS: Lymph nodes were identified in 30 rabbits (Average of 2.2 lymph nodes per animal). Of the 90 suspected lymph nodes that occurred in the study, 70 cases (77.8%) were histologically confirmed for lymphoid tissue. Of these, the majority were located in the periesophageal region of the gastric fundus. The sample presented a mortality rate of 6.25% and nine complications related to the method, which interfered in the identification of the lymph nodes. CONCLUSION: The animal model for sentinel node biopsy in rabbit stomachs proved to be feasible, with low complexity and reproduced the difficulties encountered for gastric lymph node biopsy in humans, being adequate for surgical training. Key words: Models, Animal. Sentinel Lymph Node Biopsy. Stomach. Coloring Agents. Technetium. Rabbits. RESUMO OBJETIVO:Criar e validar uma proposta de modelo animal para o treinamento em pesquisa de linfonodos sentinelas no estômago. MÉTODOS: Em trinta e dois coelhos, mediante laparotomia, foi injetado na subserosa da parede anterior do corpo gástrico, 0,1 ml de fitato marcado com tecnécio-99m (0,2 mCi), seguido pelo mesmo orifício, de 0,2 ml de Azul Patente V ® 2,5%. A cavidade abdominal foi avaliada, in vivo, por meio de inspeção para pesquisa de suspeitas de linfonodos azuis e com detector manual de radiação gamma aos cinco, dez e 20 minutos para pesquisa de suspeitas de linfonodos radioativas. Após 20 minutos, foi realizada a ressecção dessas para posterior avaliação da radioactividade (ex vivo) e estudo histológico. RESULTADOS: Foram identificados linfonodos em 30 coelhos (Média de 2,2 linfonodos por animal). Das 90 suspeitas de linfonodos ocorridas no estudo, em 70 casos (77,8%) obteve-se confirmação histológica para tecido linfóide. Destas, a maioria estava localizada na região periesofágica do fundo gástrico. A amostra apresentou taxa de mortalidade de 6,25% e nove intercorrências relacionadas ao método, que interferiram na identificação dos linfonodos. CONCLUSÃO: O modelo animal para pesquisa de linfonodos sentinelas em estômago de coelhos mostrou-se factível, pouco complexo e reproduziu as dificuldades encontradas para a pesquisa de linfonodos gástricos em humanos, sendo adequado para o treinamento cirúrgico. Descritores: Modelos Animais. Biópsia de Linfonodo Sentinela. Estômago. Corantes. Tecnécio. Coelh...

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“…The SLNB in this animal model presented a detection rate and average number of lymph nodes found per animal that were comparable with other studies on humans 5,9,15,20,21 .…”

Section: Discussionsupporting

confidence: 88%

“…Regarding the method chosen in this study, we used combined methods for SLNB 5,9,18,20,21 , through injection of RC and staining in the subserosa of the gastric wall 13,23,26 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Animal model for training in sentinel lymph node biopsy of the stomach through combined methods

Alves¹,

Lopes

Meirelles³

et al. 2012

Acta Cir. Bras.

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“…The organic combination of low invasiveness by laparoscopic gastrectomy and preservation of gastric function by SNNS will contribute to the patient's short-term and long-term quality of life, respectively [45].…”

Section: Future Perspectivementioning

confidence: 99%

A new stage of sentinel node navigation surgery in early gastric cancer

et al. 2014

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Sentinel node (SN) navigation surgery is expected to realize organ-and function-preserving surgery with SN mapping, and has been applied in operations for breast cancer and melanoma. But there has been no definite evidence for the SN concept in gastric cancer. A prospective multicenter trial to confirm the SN concept for gastric cancer conducted by the Japan Society of Sentinel Node Navigation Surgery reported that the SN detection rate, sensitivity of positive SNs, and accuracy of nodal status are 97.5 % (387/397), 93 % (53/57), and 99 % (383/ 387), respectively. A detailed analysis of the trial suggested that strictly the ''lymphatic basin concept'' rather than the ''SN concept'' was confirmed in early gastric cancer. The Japan Society of Sentinel Node Navigation Surgery started a new trial of function-preserving gastrectomy with lymphatic basin dissection (LBD) for early gastric cancer without metastasis in SNs on the basis of this promising outcome of the trial. It is supposed that LBD guarantees curability in SN navigation surgery for early gastric cancer. Full-thickness resection or endoscopic submucosal dissection in combination with laparoscopic LBD will soon be a new treatment option for early gastric cancer.

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“…La cirugía mínimamente invasiva ha presentado dos grandes áreas de desarrollo en el tratamiento del cáncer gástrico en los últimos años 8 . Un área es el tratamiento resectivo endoscópico de lesiones incipientes y otra es la cirugía resectiva laparoscópica.…”

Section: Discussionunclassified