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Sentinel node navigation surgery for gastroduodenal neuroendocrine tumors: Two case reports
Takaaki Arigami1, Yoshikazu Uenosono, Shigehiro Yanagita
1aDepartment of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology bMolecular Frontier Surgery, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Medicine
|July 2, 2016
Summary
Sentinel node navigation surgery (SNNS) shows promise for detecting lymph node metastasis in gastroduodenal neuroendocrine tumors (NETs). This technique aids in personalized surgical strategies for early-stage gastrointestinal cancers.
Area of Science:
- Oncology
- Surgical Innovation
- Gastroenterology
Background:
- Gastroduodenal neuroendocrine tumors (NETs) represent an increasing proportion of gastroenteropancreatic (GEP) NETs globally.
- Sentinel node navigation surgery (SNNS) is an emerging personalized approach for early gastrointestinal cancers.
Observation:
- This study reports on 2 cases of gastroduodenal NETs managed with SNNS.
- Technetium-tin colloid and indocyanine green were endoscopically injected submucosally around the tumor.
- Sentinel nodes (SNs) were identified using Navigator GPS and near-infrared fluorescence imaging during laparoscopic surgery.
Findings:
- SNs were successfully detected in both patients.
- Intraoperative examination revealed lymph node metastasis in one patient.
- The patient with metastatic SNs underwent laparoscopic gastrectomy with lymphadenectomy for a submucosal NET.
Implications:
- SNNS is a valuable tool for identifying subclinical lymph node metastasis in gastroduodenal NETs.
- This technique supports tailored surgical decision-making in NET management.
- SNNS enhances the precision of staging and treatment planning for these tumors.
