Objectives Recently, open radical hysterectomy in early-stage cervical cancer has been preferred after the LACC trial was published. and the role of sentinel lymph node (SLN) is increasing in the surgical treatment of cervical cancer. We evaluated the feasibility the of SLN mapping by intra-abdominal Indocyanine green (ICG) injection during open surgery for cervical cancer.
Methods We performed retrospective study at a single center. The novel technique is done by using ICG which was injected in bilateral side between the isthmus and cervix before or after bladder peritoneum dissection. SLN in open surgery was detected with SPY Portable Handheld Imager (SPY-PHI) camber (Stryker, Kalamazoo, Michigan, US). All patients underwent open SLN mapping followed by radical surgery (hysterectomy or trachelectomy) and systemic pelvic lymphadenectomy
Results From June 2020 to April 2021, thirty-three patients, newly diagnosed FIGO 2018 stage IA1 to IIIC1p cervical cancer who underwent open surgeries, were included in this study. of these patients, 29 (87.9%) radical hysterectomy and 4 (12.1%) underwent radical trachelectomy. Twenty three (69.7%) patients showed bilateral SLN detection, and the proportion of patient with at least unilateral SLN detection was 97% (32/33). Compared to the final pathology results were all consistent with the frozen biopsy results of SLN mapping. Per-patient sensitivity (5/5) and negative predictive value (28/28) of SLN biopsy were both 100%.
Conclusions SLN mapping with ICG in open method can be considered as a feasible, reliable technique to be used in open surgery for cervical cancer with high detection rate.
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