Observation on Sentinel Lymph Nodes Using an Infrared Ray Electronic Endoscopic System.

概要

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Sentinel lymph node are the first lymph nodes to flow into cancerous lesion. The dyeindocyanine green(ICG)is used as a tracer for sentinel lymph nodes diagnosis in gastric cancer.we injected ICS into tumor tissue and examined ICS in the Iymph flow using infrared light. Experimentally, the lymph du.cts were visualized as dark blu.e lines following local injectionof ICS. Clinically, ICG could also be clearly seen flowing from the lymph ducts into the sentinellymph nodes following local injection of ICG into the tumor tissue. On examination for 20 minutes during surgery, the stained sentinel lyrnph nodes basin wereone-directional in 53.5% of the patients, two-directional in 42.8%of the patients, and three-directional in 3.7%of the patients. A mean of 3.3 sentinel lymph nodes were visualized perpatient. After surgery, 26.4%of the resected lymph nodes were ICG-positive on normalendoscopic examination and 43.2%were ICG-positive on examination with infrared light. Theinfrared images became, therefore, clearer than on the normal endoscopic ones. Lymph flowand sentinel lymph nodes that were not visible with normal endoscopic image were clearlyvisualized on the infrared images, indicating that examination using infrared light is a usefulnew technique in the sentinel lymph nodes diagnosis.
社団法人日本消化器内視鏡学会の論文