Sentinel lymph node navigation surgery for early stage gastric cancer

Area of Science:

• Surgical Oncology
• Gastroenterology
• Medical Imaging

Background:

• Sentinel lymph node navigation surgery (SNNS) is crucial for staging gastrointestinal cancers.
• Early gastric cancer (EGC) has a low lymph node metastasis rate, making precise staging essential.
• Minimizing lymph node dissection in EGC can significantly improve patient outcomes and quality of life.

Purpose of the Study:

• To evaluate the history, techniques, tracers, and clinical applications of SNNS.
• To assess the utility of Infrared Ray Electronic Endoscopes (IREE) combined with Indocyanine Green (ICG) for SNNS.
• To determine the potential of SNNS in avoiding unnecessary lymph node dissection for EGC.

Main Methods:

• Review of historical data and clinical applications of SNNS.
• Utilizing Infrared Ray Electronic Endoscopes (IREE) with Indocyanine Green (ICG) as a tracer.
• Analysis of prospective multicenter trials and previous study findings on SNNS for gastric cancer.

Main Results:

• SNNS for gastric cancer has been reported since the early 2000s.
• Endoscopic dual tracer methods (dye and radioisotope) have shown effectiveness for EGC.
• ICG combined with IREE has demonstrated usefulness in detecting sentinel lymph nodes (SLNs) in gastrointestinal cancer.

Conclusions:

• SNNS, particularly using ICG and IREE, is a promising technique for EGC.
• Accurate SLN detection via SNNS can help prevent overtreatment by avoiding unnecessary lymph node dissection.
• Further development of SNNS aims for secure, accurate SLN detection with real-time lymphatic flow observation.