Methylene Blue-Assisted Lymph Node Dissection in Colon Specimens : A Prospective, Randomized Study

Recently, we introduced ex vivo intra-arterial methylene blue injection into the inferior mesenteric artery as a novel method to improve lymph node (LN) harvest in rectal cancer. We have now adapted this method to the other segments of the colon. A total of 60 cases were enrolled. Primary LN dissect...

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Bibliographic Details
Published in:	American journal of clinical pathology Vol. 130; no. 6; pp. 913 - 919
Main Authors:	MÄRKL, Bruno, KERWEL, Therese G, JDHNIG, Hendrik G, ORUZIO, Daniel, ARNHOLDT, Hans M, SCHÖLER, Claus, ANTHUBER, Matthias, SPATZ, Hanno
Format:	Journal Article
Language:	English
Published:	Chicago, IL American Society of Clinical Pathologists 01-12-2008
Subjects:	Aged Aged, 80 and over Biological and medical sciences Colon - pathology Colon - surgery Female Gastroenterology. Liver. Pancreas. Abdomen Histocytochemistry - methods Humans Injections, Intra-Arterial Investigative techniques, diagnostic techniques (general aspects) Lymph Node Excision - methods Male Medical sciences Mesenteric Artery, Inferior Methylene Blue Middle Aged Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Prospective Studies Rectum - pathology Rectum - surgery Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Tumors Lymph node staging Lymph node Digestive system Staging Lymph node clearance Stage classification Gut Malignant tumor Clearance Fat clearance Methylene blue Colonic disease Prospective Lymphadenectomy Anatomic pathology Randomization Colon cancer Fat Digestive diseases Intestinal disease Colon Cancer
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Summary:	Recently, we introduced ex vivo intra-arterial methylene blue injection into the inferior mesenteric artery as a novel method to improve lymph node (LN) harvest in rectal cancer. We have now adapted this method to the other segments of the colon. A total of 60 cases were enrolled. Primary LN dissection was followed by fat clearance and a secondary dissection. The mean +/- SD primary LN harvest differed highly significantly with 35 +/- 18 and 17 +/- 10 LNs in the methylene blue-stained and unstained groups, respectively. Primary insufficient LN harvest occurred in 8 cases of the unstained group and in only 1 case of the methylene blue-stained group (P = .0226). After secondary dissection, upstaging was seen exclusively in the unstained group. The time/LN ratio differed significantly with 0.9 and 0.6 min/LN in the unstained and methylene blue-stained groups, respectively. Intraarterial methylene blue injection is recommended as a routine technique in the histopathologic study of colon cancer.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0002-9173 1943-7722
DOI:	10.1309/AJCPVAPB5APABJNX