Kai Li, Jun Yan, Zhiyong Shen, Zhangyuanzhu Liu. Department of General Surgery, Nanfang Hospital, Southern Medical University
Inferior mesenteric artery lymph nodes metastasis occurs in approximately 0.3 to 13.9% according to different T stage in rectal cancer, which is an important prognostic factor after curative resection for rectal cancer. Pre-operative or intra-operative identification of lymph nodes around inferior mesenteric artery with or without metastasis was very helpful for decision making of D2 or D3 lymph nodes dissection in rectal cancer. This video show that the technique of using carbon nanoparticles to trace decision-making lymph nodes around inferior mesenteric artery in rectal cancer. A 67 year-old woman, colonoscopy showed a rectal tumor with a diameter of 3cm, and her biopsy reports showed well differentiated adenocarcinoma. Endoscopic ultrasonography showed the tumor has reached T4. Finally her abdominal CT also revealed distant metastasis were not found in the rectal cancer. One milliliter injection of carbon nanoparticles was endoscopically injected into submucosal layer of primary tumor one day before surgery. Obviously, Under laparoscopy, we can easily found primary tumor and decision-making lymph nodes around inferior mesenteric artery in rectal cancer. In this case, we performed laparoscopic radical resection with D3 lymphadenectomy, we clear 8 decision-making lymph nodes that black-dyed by carbon nanoparticle lie along the inferior mesenteric artery proximal to the origin of the left colic artery. These decision-making lymph nodes received intra-operative frozen pathological examination, and pathological confirmation is consistent with pathological examination of post-operative 253 lymph nodes. After surgery, the patients was diagnosed with rectal cancer (pT2N0M0). From our video, we can conclude that it is feasible to use carbon nanoparticles to show decision-making lymph nodes around inferior mesenteric artery in rectal cancer.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87531
Program Number: V198
Presentation Session: Wednesday Video Loop (Non CME)
Presentation Type: VideoLoop