Introduction/Background The sentinel node procedure helps to assess the nodal status in patients with low or intermediate risk groups helping in avoiding complete nodal dissection in endometrial cancers. The rate of identification of a sentinel node varied from 80% to 100%. Indocyanine green dye has shown a better detection rate when compared to the other tracers.
Methodology The aim of this study was to evaluate the feasibility of laparoscopic sentinel lymph node mapping using Indocyanine green (ICG) in early endometrial cancers. This was a prospective study done from January 2020 to June 2021 with a sample size of 25.
ICG dye was injected superficial and deep at the 3 O’clock and 9 O’clock positions of the cervix. Fluorescent signal from the sentinel nodes was identified and sentinel nodes were excised. Patients underwent total laparoscopic hysterectomy with bilateral salpingo-oophorectomy and a complete pelvic and para-aortic lymph node dissection.
Results The average duration of surgery was 4.8 hours. Hospital stay was 4 days.
Sentinel nodes were identified in 84% patients. Number of sentinel nodes isolated was 125 with a mean of 5 per patient. The Sentinel node detection rate was 84%. The detection rate in the right hemipelvis was 72% and in the left hemipelvis was 60%.
Around 56% of patients had sentinel node detection in bilateral hemipelvis. The sentinel node was detected in the para-aortic area for 44% of patients. The total number of lymph nodes obtained by lymphadenectomy was 394 with a mean of 15.7. Metastasis was identified in 8% of cases in the final histopathology in the pelvic sentinel node. No metastasis was detected in non-sentinel pelvic and paraaortic lymphadenectomy specimen
Conclusion Laparoscopic staging with sentinel node biopsy using ICG dye for
Endometrial cancers are safe, easily reproducible and has a high detection rate.
Disclosures There are no conflicts of interest .
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