Laparoscopic ultrasonography-assisted retroperitoneal lymph node sampling in patients evaluated for stomach cancer recurrence.

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Authors: Honsoul Kim ; Woo Jin Hyung ; Joon Seok Lim ; Mi-Suk Park ; Jin Young Choi ; Yong Eun Chung ; Myeong-Jin Kim ; Ki Whang Kim

MeSH: Aged ; Humans ; Laparoscopy/methods* ; Lymph Nodes/diagnostic imaging* ; Lymph Nodes/pathology* ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local/diagnosis* ; Sentinel Lymph Node Biopsy/methods* ; Stomach Neoplasms/diagnosis* ; Stomach Neoplasms/secondary* ; Ultrasonography, Interventional/methods*

Keywords: Aged ; Humans ; Laparoscopy/methods* ; Lymph Nodes/diagnostic imaging* ; Lymph Nodes/pathology* ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local/diagnosis* ; Sentinel Lymph Node Biopsy/methods* ; Stomach Neoplasms/diagnosis* ; Stomach Neoplasms/secondary* ; Ultrasonography, Interventional/methods*

Abstract: OBJECTIVE: The precise localization of target lymph nodes during laparoscopic biopsy can often be technically challenging. The purpose of this series was to report 2 patients who successfully underwent laparoscopic para-aortic lymph node sampling with the assistance of laparoscopic ultrasonography (LUS).

METHODS: We describe 2 patients previously treated for gastric cancer who later had suspicious retroperitoneal lymphadenopathy detected by computed tomography. They received LUS-assisted lymph node biopsies for histologic evaluation.

RESULTS: Laparoscopic ultrasonography precisely localized the target lymph nodes, which measured 1.4 and 1.5 cm, respectively, in both patients. A transperitoneal laparoscopic approach and target lymph node sampling were successfully performed. No procedure-related technical difficulties or immediate complications occurred. The 2 patients were histologically proven to have nodal tumor recurrence and tuberculous lymphadenopathy, respectively.

CONCLUSIONS: Precise localization of a small lymph node located deep in the abdomen can be readily performed by intraoperative LUS