J.Jpn. Surg. Soc.. 80(12): 1497-1500, 1979
Report on the annual meeting
CLINICAL STUDIES ON LYMPH NODE DISSECTION IN ESOPHAGEAL CANCER
―PREOPERATIVE LYMPHOGRAPHY AND TOPICAL APPLICATION OF BLEOMYCIN―
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*) Department of Surgery II, Kyushu University, School of Medicine, Fukuoka 812, Japan Keizo Sugimachi*), Yasunori Natsuda*), Hiroaki Ueo*), Yasuyuki Okudaira*), Masahito Ikeda*), Kiyoshi Inokuchi*), Teruhisa Nakamura**), Akira Yaita**) |
1) Cervical and mediastinal lymphography is successfully achieved in the patients of esophageal cancer by injection of lipiodol into the thyroid and subcarinal lymph nodes. Preoperative visualization of metastatic lymph node is clinically very important. Because, it is impossible to remove all the mediastinal lymph node for postoperative pulmonary complication. However, if metastatic lymph nodes have been confirmed preoperatively, dissection of metastatic lymph node is able to be carefully performed.
2) After right thoracotomy the azygos vein is divided to expose the esophagus. Then, BLM is injected into the subcarinal lymph nodes. BLM spreads in all mediastinal lymph node including metastatic one within 30 minutes. We have clinically used emulsion type BLM in 17 cases of esophageal cancer. BLM was detectable in 12 out of 22 metastatic lymph nodes (54.5%), and 13 out of 40 (32.5%) non-metastatic lymph nodes.
3) We remove not only paraesophageal lymph nodes but also subcarinal, paratracheal, diaphragmatic, posterior mediastinal lymph node in many cases. Metastatic lymph nodes were histologically proved in 47 out of 144 cases of thoracic esophageal cancer (32.6%).
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