TY - JOUR
T1 - Accurate, safe, and rapid method of intraoperative tumor identification for totally laparoscopic distal gastrectomy
T2 - Injection of mixed fluid of sodium hyaluronate and patent blue
AU - Nakagawa, Masatoshi
AU - Ehara, Kazuhisa
AU - Ueno, Masaki
AU - Tanaka, Tsuyoshi
AU - Kaida, Sachiko
AU - Udagawa, Harushi
PY - 2014/4
Y1 - 2014/4
N2 - Background: In totally laparoscopic distal gastrectomy, determining the resection line with safe proximal margins is often difficult, particularly for tumors located in a relatively upper area. This is because, in contrast to open surgery, identifying lesions by palpating or opening the stomach is essentially impossible. This study introduces a useful method of tumor identification that is accurate, safe, and rapid. Methods: On the operation day, after inducing general anesthesia, a mixture of sodium hyaluronate and patent blue is injected into the submucosal layer of the proximal margin. When resecting stomach, all marker spots should be on the resected side. In all cases, the proximal margin is examined histologically by using frozen sections during the operation. Results: From October 2009 to September 2011, a prospective study that evaluated this method was performed. A total of 34 patients who underwent totally laparoscopic distal gastrectomy were enrolled in this study. Approximately 5 min was required to complete the procedure. Proximal margins were negative in all cases, and the mean ± standard deviation length of the proximal margin was 23.5 ± 12.8 mm. No side effects, such as allergy, were encountered. Conclusions: As a method of tumor identification for totally laparoscopic distal gastrectomy, this procedure appears accurate, safe, and rapid.
AB - Background: In totally laparoscopic distal gastrectomy, determining the resection line with safe proximal margins is often difficult, particularly for tumors located in a relatively upper area. This is because, in contrast to open surgery, identifying lesions by palpating or opening the stomach is essentially impossible. This study introduces a useful method of tumor identification that is accurate, safe, and rapid. Methods: On the operation day, after inducing general anesthesia, a mixture of sodium hyaluronate and patent blue is injected into the submucosal layer of the proximal margin. When resecting stomach, all marker spots should be on the resected side. In all cases, the proximal margin is examined histologically by using frozen sections during the operation. Results: From October 2009 to September 2011, a prospective study that evaluated this method was performed. A total of 34 patients who underwent totally laparoscopic distal gastrectomy were enrolled in this study. Approximately 5 min was required to complete the procedure. Proximal margins were negative in all cases, and the mean ± standard deviation length of the proximal margin was 23.5 ± 12.8 mm. No side effects, such as allergy, were encountered. Conclusions: As a method of tumor identification for totally laparoscopic distal gastrectomy, this procedure appears accurate, safe, and rapid.
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U2 - 10.1007/s00464-013-3319-3
DO - 10.1007/s00464-013-3319-3
M3 - Article
C2 - 24263460
AN - SCOPUS:84899109669
SN - 0930-2794
VL - 28
SP - 1371
EP - 1375
JO - Surgical endoscopy
JF - Surgical endoscopy
IS - 4
ER -