Instilación de azul de metileno intravascular ex vivo en piezas de esofaguectomía y gastrectomía y su implicación en la evaluación histopatológica tumoral

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola Pub Date : 2025-02-01 DOI:10.1016/j.ciresp.2024.12.002

Carmen Gutiérrez Sánchez, Marta Nieto Sánchez, Miriam Menéndez Jiménez de Zadava Lisson, Marcos Bruna Esteban

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Abstract

Surgical resection and lymphadenectomy are the central mainstay of curative treatment of esophagogastric cancer. In this study we evaluate the results of intravascular methylene blue injection into esophagectomy and gastrectomy specimens as a tool to increase lymph node detection.

A prospective and descriptive study was performed in 24 patients (11 esophagus, 13 stomachs). The most frequent histological type was adenocarcinoma (esophagus 29.2%, stomach 90.9%). All patients with esophageal cancer received neoadjuvant treatment, compared to 8 with gastric cancer. The anatomopathological analysis of esophagectomies showed a median of 42 isolated nodes, compared to 46 in gastrectomies. In esophageal cancer, a total of 8 (72.7%) patients did not show lymphatic involvement, whereas, in gastric cancer patients, 76.9% of patients had lymph nodes, with a median number of positive nodes of 3 (RIC: 0.5-7).

The instillation of methylene blue allows a large number of nodes to be analysed and could atherefore improve staging, treatment and prognosis of patients with esophagogastric cancer.

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在胃和食道切除术中注入活体内蓝甲烯及其对肿瘤组织病理学评估的影响

手术切除和淋巴结切除术是食管胃癌根治性治疗的中心支柱。在这项研究中，我们评估了在食管切除术和胃切除术标本中血管内注射亚甲基蓝作为增加淋巴结检测的工具的结果。对24例患者（11例食道，13例胃）进行前瞻性描述性研究。最常见的组织学类型为腺癌（食管29.2%，胃90.9%）。所有食管癌患者均接受了新辅助治疗，而胃癌患者只有8例。食管切除术的解剖病理分析显示中位数为42个孤立淋巴结，而胃切除术中位数为46个。在食管癌中，共有8例（72.7%）患者未表现出淋巴结累及，而在胃癌患者中，76.9%的患者有淋巴结，阳性淋巴结中位数为3个（RIC: 0.5-7）。亚甲基蓝的灌注可以对大量淋巴结进行分析，从而改善食管胃癌患者的分期、治疗和预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cirugia Espanola SURGERY-

CiteScore

1.20

自引率

21.10%

发文量

173

审稿时长

53 days

期刊介绍： Cirugía Española, an official body of the Asociación Española de Cirujanos (Spanish Association of Surgeons), will consider original articles, reviews, editorials, special articles, scientific letters, letters to the editor, and medical images for publication; all of these will be submitted to an anonymous external peer review process. There is also the possibility of accepting book reviews of recent publications related to General and Digestive Surgery.