J.Jpn. Surg. Soc.. 83(3): 264-276, 1982

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Original article

EXPERIMENTAL AND CLINICAL STUDIES ON INTRALYMPHATIC ADMINISTRATION OF BLEOMYCIN FOR ESOPHAGEAL CANCER

In actual procedure of surgery for esophageal cancer, adequate dissection of metastatic lymph nodes in the upper mediastinum is generally difficult, and hence the author designed an intraoperative administration of emulsion type BLM into the lymph nodes of tracheal bifurcation, which are located at the anatomical pivot in upper mediastinal lymph flow.
When emulsion type BLM was injected into the bifurcation lymph nodes of mongrel dogs, the level of BLM in the bilateral paratracheal lymph nodes reached the maximum in 20 minutes. When the cervical and upper mediastinal lymph nodes in the ipsilateral side were dissected beforehand, BLM level in those of the contralateral side became twice as much as the otherwise case.
In rabbits with Vx2 carcinoma the level of BLM was lower in proportion as metastasized area in the lymph nodes increased, but the diffusion was not completely obstructed even when the metastasized area was more than 75%.
In 17 patients with esophageal cancer, 30mg of emulsion type BLM was intraoperatively administered into the bifurcation lymph nodes. BLM was found to be detected in 31 of 75 (41.3%) dissected lymph nodes and higher density was found in thoracic paratracheal, paraesophageal and pulmonary hilar lymph nodes.

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