Intraoperative lymphatic mapping in esophago-gastric junction adenocarcinoma
Memorial Sloan Kettering Cancer Center, New York, NY, USA.
OBJECTIVE: To evaluate the lymphatic drainage distribution in patients with esophageal adenocarcinoma of the esophago-gastric junction
METHODS: Patients undergoing minimally invasive esophagectomy were injected with 2 cc (1.25mg/mL) of Indocyanine Green into the esophageal submucosa at the four quadrants around the tumor before initiating the laparoscopic phase of surgery. Pattern of drainage was recorded
RESULTS: Visualization of the lymphatic drainage was prompt after injection. This video shows the injection technique and the laparoscopic visualization of the lymphatic drainage.
CONCLUSIONS: Understanding pattern of drainage for esophago-gastric junction tumors can guide the surgeon to a targeted lymphadenectomy. Sentinel node identification may also be possible and valuable.
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