Author/Editor		Di Stefano, Andrea B; Acquaviva, Giusi; Garozzo, Gaetano; Barbič, Matija; Cvjetičanin, Branko; Meglič, Leon; Kobal, Borut; Rakar, Stelio
Title		Lymph node mapping and sentinel node detection in patients with cervical carcinoma: a 2-year experience
Type		članek
Source		Obstet Gynecol Surv
Vol. and No.		Letnik 61, št. 4
Publication year		2006
Volume		str. 243-4
Language		eng
Abstract		The authors present their experience with the detection of the sentinel node, which is the first node to receive drainage from a malignant tumor, in patients with cervical cancer. Fifty women who were scheduled to undergo radical abdominal hysterectomy and systematic pelvic lymphadenectomy for treatment of stage IA2 to IIA primary carcinoma of cervix from January 2003 to January 2005 served as study subjects. Sentinel lymph node (SNL) mapping was done with an intracervical injection of 4 mL methylene blue. Pelvic lymph nodes appeared blue 15 minutes after dye injection and remained colored for 70 minutes. A 25-gauge standard needle was used to slowly, under constant pressure, inject the dye into the cervix to a depth of 5 to 10 mm at 3, 6, 9, and 12 o'clock positions, taking care to avoid injecting into the tumor itself. The abdomen was then opened, and the right retroperitoneal space on the right pelvis was opened. Using blunt dissection, the avascular paravesical and pararectal spaces were developed. The blue lymphatics could then be followed to the first node with obvious or faint dye uptake. This sentinel node was dissected and removed. The procedure was repeated on the left side before proceeding with lymphadenectomy. After the SNLs were removed on both sides, bilateral pelvic lymphadenectomy followed by radical hysterectomy was performed in all patients. The technique was considered to have failed when no sentinel node was identified or when there was inadequate injection of the dye. If the SNL was negative on histology, but other nodes in the drainage area were positive, the outcome was considered to be a false-negative. Sentinel nodes were considered positive when they contained macrometastases, micrometastases, or isolated tumor cells. (Abstract truncated at 2000 characters)
Descriptors		CERVIX NEOPLASMS LYMPHATIC METASTASIS METHYLENE BLUE NEOPLASM STAGING