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Sentinel lymph node mapping with indocyanine green in vaginal cancer

 In Ok Lee  ;  Jung-Yun Lee  ;  Sunghoon Kim  ;  Sang Wun Kim  ;  Young Tae Kim  ;  Eun Ji Nam 
 Journal of Gynecologic Oncology, Vol.28(4) : e29, 2017 
Journal Title
 Journal of Gynecologic Oncology 
Issue Date
Adult ; Carcinoma, Squamous Cell/pathology* ; Carcinoma, Squamous Cell/surgery ; Coloring Agents ; Female ; Humans ; Indocyanine Green ; Laparoscopy ; Lymph Node Excision* ; Optical Imaging ; Sentinel Lymph Node/diagnostic imaging* ; Sentinel Lymph Node/pathology ; Sentinel Lymph Node/surgery ; Vaginal Neoplasms/pathology* ; Vaginal Neoplasms/surgery
Indocyanine Green ; Neopla는 ; Sentinel Lymph Node ; Vaginal diseases
OBJECTIVE: Sentinel lymph node (SLN) mapping is being adapted to gynecologic cancer. Higher SLN mapping rates were reported with indocyanine green (ICG) compared to other dyes. The aim of this film is to share our experience of SLN mapping with ICG in vaginal cancer. METHODS: A 40 year-old woman was diagnosed with squamous cell vaginal cancer. About 1.5 cm-sized tumor was located on the posterior vaginal fornix. Preoperatively she was assumed to be stage I vaginal cancer. Beginning of surgery, we performed SLN mapping by ICG injection into 3- and 9-o'clock positions of the vaginal tumor. Concentrated in 1.25 mg/mL, 1 mL of ICG solution was injected into deep stroma and another 1 mL submucosally in both sides. Bilateral SLN identification and lymphadenectomy were done. Afterward, laparoscopic Type C1 Querleu-Morrow radical hysterectomy with vaginectomy was done. A fluorescence endoscope produced by KARL STORZ (Tuttlingen, Germany) was used for ICG detection. RESULTS: To our knowledge, this is the first film report performing SLN mapping with ICG in vaginal cancer. The mapping was successful and we were able to recognize SLN of vaginal cancer. SLNs were located in the bilateral obturator fossa. According to the pathologic diagnosis, the mass size was 15 mm and invasion depth was 1 mm. Subvaginal tissue involvement and pelvic wall extension were absent. Resection margin of the vagina was free from carcinoma. No lymph node metastasis was reported including the bilateral SLNs. CONCLUSION: For vaginal cancer, SLN mapping can be applied by injecting ICG into the bilateral sides of the vaginal tumor.
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1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
김상운(Kim, Sang Wun) ORCID logo https://orcid.org/0000-0002-8342-8701
김성훈(Kim, Sung Hoon) ORCID logo https://orcid.org/0000-0002-1645-7473
김영태(Kim, Young Tae) ORCID logo https://orcid.org/0000-0002-7347-1052
남은지(Nam, Eun Ji)
이인옥(Lee, In Ok)
이정윤(Lee, Jung-Yun) ORCID logo https://orcid.org/0000-0001-7948-1350
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