J Gastric Cancer.  2018 Mar;18(1):30-36. 10.5230/jgc.2018.18.e6.

Safety of Laparoscopic Sentinel Basin Dissection in Patients with Gastric Cancer: an Analysis from the SENORITA Prospective Multicenter Quality Control Trial

• An JY
• Min JS
• Lee YJ
• Jeong SH
• Hur H
• Han SU
• Hyung WJ
• Cho GS
• Jeong GA
• Jeong O
• Park YK
• Jung MR
• Park JY
• Kim YW
• Yoon HM
• Eom BW
• Ryu KW
• Sentinel Node Oriented Tailored Approach (SENORITA) Study Group

• KMID: 2414544
• DOI: http://doi.org/10.5230/jgc.2018.18.e6

Abstract

PURPOSE
We investigated complications after laparoscopic sentinel basin dissection (SBD) for patients with gastric cancer who were enrolled in a quality control study, prior to the phase III trial of sentinel lymph node navigation surgery (SNNS).
MATERIALS AND METHODS
We analyzed prospective data from a Korean multicenter prerequisite quality control trial of laparoscopic SBD for gastric cancer and assessed procedure-related and surgical complications. All complications were classified according to the Clavien-Dindo Classification (CDC) system and were compared with the results of the previously published SNNS trial.
RESULTS
Among the 108 eligible patients who were enrolled in the quality control trial, 8 (7.4%) experienced complications during the early postoperative period. One patient with gastric resection-related duodenal stump leakage recovered after percutaneous drainage (grade IIIa in CDC). The other postoperative complications were mild and patients recovered with supportive care. No complications were directly related to the laparoscopic SBD procedure or tracer usage, and there were no mortalities. The laparoscopic SBD complication rates and patterns that were observed in this study were comparable to those of a previously reported trial.
CONCLUSIONS
The results of our prospective, multicenter quality control trial demonstrate that laparoscopic SBD is a safe procedure during SNNS for gastric cancer.

Keyword

Stomach neoplasms; Sentinel lymph node biopsy; Postoperative complication

MeSH Terms

Classification
Drainage
Humans
Lymph Nodes
Mortality
Postoperative Complications
Postoperative Period
Prospective Studies*
Quality Control*
Sentinel Lymph Node Biopsy
Stomach Neoplasms*

Figure

• 

  Fig. 1 The steps of laparoscopic SBD. (A) Endoscopic injection of Tc99m-HSA with ICG and a laparoscopic view after tracer injection. (B) Laparoscopic sentinel basin node detection along the greater and lesser curvatures of the stomach. (C) Surgical clip application for marking the extent of laparoscopic SBD in the greater and lesser curvatures of the stomach. (D) Laparoscopic SBD along the greater and lesser curvatures of the stomach. (E) Completion of laparoscopic SBD along the greater and lesser curvatures of the stomach.SBD = sentinel basin dissection; ICG = indocyanine green.

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