Methodology: Dye and Isotope Method

  • Shinichi KinamiEmail author
  • Takeo Kosaka


Sentinel node (SN) biopsy has been attempted for digestive tract cancers, including esophageal, gastric, colon, and rectal cancers. Among these cancers, tailor-made surgical procedures guided by SN navigation have been planned for gastric cancer, while ultrastaging by SN biopsy is conducted for colon cancer. SN biopsy is a complex multistep surgical technique. This technique requires a suitable limitation of the indication, the selection of an adequate tracer, a proper tracer injection method, the objective detection of tracer uptake by the nodes, a reliable biopsy technique for the nodes that showed tracer uptake, and the precise detection of nodal metastasis. The selection of an adequate tracer for SN mapping has been an important issue. The advantages of dye methods are low cost, tractable, no radioactivity, and the direct visualization of the lymphatic canals and primary lymphatic drainage areas. The disadvantages of dye method are lack of objectivity, difficulty for digitizing, and quick washing out and deterioration. The advantages of radioactive imaging (RI) methods are high detection ability, objectivity, ease of digitizing, and possibility of easily distinguishing SN from secondary nodes. The disadvantages of the RI method are high cost, difficulty in handling, exposure to radioactivity, difficulty in detection of lymphatic vessels and lymphatic basin, and shine-through effect in the surgical field. Therefore, combination mapping of the dye method and the RI method is recommended because of its synergistic effect. Surgeons can detect both primary lymphatic canals visually and the SN objectively.


Sentinel node Gastric cancer Combination mapping 


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Surgical OncologyKanazawa Medical UniversityIshikawaJapan

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