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ORIGINAL ARTICLE
Year : 2017  |  Volume : 30  |  Issue : 1  |  Page : 221-226

Evaluation of lymph node harvest using intra-arterial methylene blue injection into ex-vivo colorectal cancer specimens


1 Department of General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
3 Damanhur Oncology Center, Damanhur, Beheira Governorate, Egypt

Correspondence Address:
Mahmoud M. H. Khalil
Damanhur Oncology Center, Damanhur, Beheira Governorate, 22511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_551_16

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Objective The aim of this work was to evaluate the effect of ex-vivo methylene blue injection into the feeding artery (or arteries) of the specimen removed for colorectal cancer to improve lymph node harvest and staging through a randomized controlled trial. Background TNM stage of colorectal cancer with exact nodal staging correlates with survival rates and prognosis estimation and it is the foundation on which all treatment regimens are based. Patients and methods This prospective, clinical, randomized study included 50 patients suffering from colorectal cancer. They were divided into two groups: group I (the study group), in which surgically resected specimens were subjected to ex-vivo methylene blue injection into the feeding mesocolic artery, followed by pathological assessment, and group II (the control group), in which the routine conventional pathological assessment was carried out. Results As regards the total number of harvested lymph nodes, the number of positive metastatic lymph nodes, and the postoperative pathological staging, there was a statistically significant difference between the two groups. There were no statistically significant differences between the two groups with respect to demographic data, tumor anatomical site, histological criteria, preoperative staging, and type of operation. Conclusion Ex-vivo methylene blue injection into the feeding mesocolic artery is a simple, easy, and safe method that significantly improves lymph node harvesting in colorectal cancer leading to a more accurate colorectal cancer staging.


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