Laparoscopic sentinel node mapping for colorectal cancer using infrared ray laparoscopy.

BACKGROUND Sentinel lymph node (SN) mapping by dye injection on conventional laparoscopy (CL) is often precluded by the presence of mesenteric adipose tissue in patients with colorectal cancer. SN mapping on CL was compared with that on infrared ray laparoscopy (IRL) during laparoscopy-assisted colectomy (LAC). PATIENTS AND METHODS Forty-eight patients with colorectal cancer who underwent LAC were enrolled. The tumor was identified by intra-operative fluoroscopy with marking clips. The tumor was stained intra-operatively by peritumoral injection of indocyanine green dye. SNs were observed by CL and by IRL. RESULTS In all 48 patients, dye injection and tumor localization during LAC were successful. The identification of SNs on IRL was approximately five times better than that on CL. There were no false-negative cases in T1 and T2 disease by IRL. CONCLUSION SN mapping on IRL is superior to that on CL. SN mapping by IRL might be feasible for T1 and T2 tumors.