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Peng YJ, Chen CM, Li YF, Guo YT, Chen YT, Chao KH, Yang JJ. Patent blue versus methylene blue and indigo carmine as a better dye for chromodiscography: in vitro staining efficacy and cytotoxicity study using bovine coccygeal intervertebral discs. Spine J 2023; 23:1079-1087. [PMID: 36804435 DOI: 10.1016/j.spinee.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 02/13/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND CONTEXT Chromodiscography is an integral part of full-endoscopic discectomy (FED), comprising ordinary discography with radiopacity produced by contrast medium and intradiscal stain for visualizing annular defects in the endoscopic field. Nevertheless, concerns remain about the cytotoxicity of the stains used. The study of their staining efficacy is also lacking. PURPOSE To evaluate the feasibility of methylene blue, patent blue, and indigo carmine for intradiscal injection, investigate the effectiveness of each dye, and define critical concentration with adequate staining efficacy and tolerable cytotoxicity for use in chromodiscography during FED. STUDY DESIGN An experimental in vitro study. METHODS Dye stock solutions were prepared from powder. The stock was diluted with culture medium or balanced saline and used for cytotoxicity or intervertebral disc staining assays, respectively. Bovine tails were obtained from the local slaughterhouse and functional spine units of intervertebral discs were acquired by transverse incision at the disc level. Each disc was punctured over the posterolateral aspect using a surgical knife to simulate an annular defect. The intradiscal injection was performed with each dye at different concentrations using a 22G needle from the contralateral aspect of the punctured site. Staining efficacy was quantified using ImageJ software. Primary cells of bovine tails were cultivated in each dye at different concentrations. Cytotoxicity was assessed 24 hours after stain exposure using the CCK-8 toxicity assay. RESULTS Staining efficacy and cytotoxicity were proportional to the concentration of tested dyes. Lower limits of concentration producing significant staining efficacy of indigo carmine, methylene blue, and patent blue were 0.25 mg/mL, 0.25 mg/mL, and 0.05 mg/mL, respectively. Compared with controls, concentrations showing significant toxicity for indigo carmine, methylene blue, and patient blue were 1 mg/mL, 0.5 mg/mL, and 2.5 mg/mL, respectively. CONCLUSIONS Patent blue can serve as a more suitable tissue stain than either indigo carmine or methylene blue due to the widest range of tradeoff concentration within 0.05 to 2.5 mg/mL. CLINICAL SIGNIFICANCE Patent blue with the characteristic of good staining efficacy and lower cytotoxicity may be a promising option for chromodiscography during FED.
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Affiliation(s)
- Yi-Jen Peng
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Cheng-Gong Road Section 2, Taipei 114, Taipei, 114, Taiwan, R.O.C
| | - Chiu-Ming Chen
- Department of Orthopaedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Cheng-Gong Road Section 2, Taipei 114, Taipei, 114, Taiwan, R.O.C
| | - Yao-Feng Li
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Cheng-Gong Road Section 2, Taipei 114, Taipei, 114, Taiwan, R.O.C
| | - Yi-Tzu Guo
- Institute of Pathology and Parasitology, National Defense Medical Center, No. 325, Sec. 2, Cheng-Gong Rd., Neihu Dist., Taipei 114, Taiwan, R.O.C
| | - Yi-Ting Chen
- Graduate Institute of Medical Sciences, National Defense Medical Center, No. 325, Sec. 2, Cheng-Gong Rd., Neihu Dist., Taipei 114, Taiwan, R.O.C
| | - Kuo-Hua Chao
- Department of Orthopaedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Cheng-Gong Road Section 2, Taipei 114, Taipei, 114, Taiwan, R.O.C
| | - Jui-Jung Yang
- Department of Orthopaedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Cheng-Gong Road Section 2, Taipei 114, Taipei, 114, Taiwan, R.O.C..
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Yasunaga Y, Nakajima Y, Mimura S, Yuzuriha S, Kondoh S. Magnetic resonance lymphography as three-dimensional navigation for lymphaticovenular anastomosis in patients with leg lymphedema. J Plast Reconstr Aesthet Surg 2020; 74:1253-1260. [PMID: 33277216 DOI: 10.1016/j.bjps.2020.10.099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 09/29/2020] [Accepted: 10/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Precise mapping of functional lymphatic vessels is essential for successful lymphaticovenular anastomosis (LVA). This study aimed to clarify the precision of magnetic resonance lymphography (MRL) in detecting lymphatic vessels prior to LVA. METHODS Eighteen patients with leg lymphedema were recruited for this prospective study. All patients underwent MRL before LVA to obtain three-dimensional coordinates of lymphatic vessels from MRL images. The precision of MRL for detecting lymphatic vessels was evaluated and compared with those of other contrast techniques. RESULTS Twenty legs from 18 patients were analyzed. A total of 40 skin incisions were made, 32 of which were determined by MRL. The precision of MRL to detect lymphatic vessels was 94%. With the addition of MRL, the number of lymphatic vessels identified preoperatively was increased as compared with indocyanine green lymphography (ICG-L) alone. Assuming a detection sensitivity of MRL for lymphatic vessels of 1, those of other contrast techniques were 0.90 for ICG-L under microscopy, 0.73 for patent blue staining, and 0.43 for ICG-L before incision. Whereas ICG-L before incision could not detect lymphatic vessels at depths greater than 17.0 mm, all deeper anastomosed lymphatic vessels were identified by MRL. CONCLUSION Lymphatic vessels enhanced on MRL can be reliably identified intraoperatively. MRL is a promising preoperative examination in LVA that can selectively depict suitable lymphatic vessels even in deep tissue layers.
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Affiliation(s)
- Yoshichika Yasunaga
- Division of Plastic and Aesthetic Surgery, Ina Central Hospital, Ina, Japan; Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center, Nagaizumi, Japan.
| | - Yuta Nakajima
- Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center, Nagaizumi, Japan
| | - Shinei Mimura
- Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center, Nagaizumi, Japan
| | - Shunsuke Yuzuriha
- Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shoji Kondoh
- Division of Plastic and Aesthetic Surgery, Ina Central Hospital, Ina, Japan
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Frountzas M, Karathanasis P, Vrakopoulou GZ, Theodoropoulos C, Zografos CG, Schizas D, Zografos GC, Michalopoulos NV. Kounis syndrome after patent blue dye injection for sentinel lymph node biopsy. Breast Cancer 2020; 27:1191-1197. [PMID: 32601801 DOI: 10.1007/s12282-020-01129-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/22/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Kounis syndrome (KS) has been described as an acute coronary syndrome (ACS) associated with an anaphylactic reaction. Several triggers have been identified and the diagnostic and treatment process can be challenging. CASE A 58-year-old, female patient diagnosed with breast cancer and no history of allergies had subcutaneous injection of patent blue V dye for sentinel lymph node biopsy (SLNB). Intraoperatively, she developed anaphylactic shock and was transferred to the intensive care unit (ICU). A few hours later, electrocardiographic alterations and elevation of blood troponin were observed. Emergency coronary angiography revealed no occlusive lesions in coronary vessels. Further investigation in the allergy department set the diagnosis of KS. CONCLUSION There are just ten cases of perioperative KS in the literature so far and here we present the first one triggered by patent blue V dye for sentinel node biopsy.
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Affiliation(s)
- Maximos Frountzas
- 1st Department of Propaedeutic Surgery, Medical School, "Hippocratio" General Hospital, University of Athens, 114 Vas. Sophias Av, 11527, Athens, Greece.
| | - Panagiotis Karathanasis
- 1st Department of Propaedeutic Surgery, Medical School, "Hippocratio" General Hospital, University of Athens, 114 Vas. Sophias Av, 11527, Athens, Greece
| | - Gavriella Zoi Vrakopoulou
- 1st Department of Propaedeutic Surgery, Medical School, "Hippocratio" General Hospital, University of Athens, 114 Vas. Sophias Av, 11527, Athens, Greece
| | - Charalampos Theodoropoulos
- 1st Department of Propaedeutic Surgery, Medical School, "Hippocratio" General Hospital, University of Athens, 114 Vas. Sophias Av, 11527, Athens, Greece
| | - Constantinos G Zografos
- 1st Department of Surgery, Medical School, University of Athens, "Laiko" General Hospital, 17 Agiou Thoma St, 11527, Athens, Greece
| | - Dimitrios Schizas
- 1st Department of Surgery, Medical School, University of Athens, "Laiko" General Hospital, 17 Agiou Thoma St, 11527, Athens, Greece
| | - George C Zografos
- 1st Department of Propaedeutic Surgery, Medical School, "Hippocratio" General Hospital, University of Athens, 114 Vas. Sophias Av, 11527, Athens, Greece
| | - Nikolaos V Michalopoulos
- 1st Department of Propaedeutic Surgery, Medical School, "Hippocratio" General Hospital, University of Athens, 114 Vas. Sophias Av, 11527, Athens, Greece
- 4th Dept. of Surgery, Medical School, "Attikon" University Hospital, University of Athens, 1 Rimini St, 12462, Chaidari, Greece
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Ko KH, Huang TW, Lee SC, Chang WC, Gao HW, Hsu HH. A simple and efficient method to perform preoperative pulmonary nodule localization: CT-guided patent blue dye injection. Clin Imaging 2019; 58:74-79. [PMID: 31279987 DOI: 10.1016/j.clinimag.2019.06.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/30/2019] [Accepted: 06/26/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the efficacy of computed tomography (CT)-guided localization with the injection of a low dose of patent blue dye (PBD) for the thoracoscopic resection of pulmonary nodules. MATERIALS AND METHODS Overall, 125 consecutive patients underwent CT-guided localization with injection of a lower dose of PBD between June 2015 and June 2016. The total injection dose relative to the distance between nodules and the visceral pleura was recorded. The clinical and radiological characteristics, technical details, pathological results and procedure-related complications were reviewed. RESULTS A total of 137 indeterminate pulmonary nodules were identified. The mean nodule size was 9.5 (3.0-22.0) mm. The mean injection dose of PBD relative to the distance between nodules and the visceral pleura was classified as follows: 0.07 ml: <1 cm, 0.1 ml: 1-2 cm and 0.18 ml: >2 cm. The mean time of CT-guided localization was 16.5 (10-50) min. The mean time interval from localization to surgery was 188 (24-1440) min. Pneumothorax developed in 50 patients (40%), and focal parenchymal hemorrhage occurred in 16 patients (12.8%) after localization. No patient required chest tube placement or emergent resuscitation. The success rate of dye marking was 98.5% (135/137). Malignancies, including 82 lung cancers, were diagnosed in 97 nodules (70.8%). CONCLUSION The injection of a lower dose PBD based on the distance to the visceral pleura can be successful with nodular localization and may facilitate thoracoscopic surgery, even in cases with a long interval from localization to surgery.
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Affiliation(s)
- Kai-Hsiung Ko
- Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tsai-Wang Huang
- Department of Thoracic Surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Shih-Chun Lee
- Department of Thoracic Surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Chou Chang
- Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Hong-Wei Gao
- Department of Pathology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Hsian-He Hsu
- Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China.
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El Bekkali C, Bouyarmane H, Saoiabi S, El Karbane M, Rami A, Saoiabi A, Boujtita M, Laghzizil A. Low-cost composites based on porous titania-apatite surfaces for the removal of patent blue V from water: Effect of chemical structure of dye. J Adv Res 2016; 7:1009-1017. [PMID: 27857847 PMCID: PMC5106448 DOI: 10.1016/j.jare.2016.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 05/05/2016] [Accepted: 05/06/2016] [Indexed: 11/25/2022] Open
Abstract
Hydroxyapatite/titania nanocomposites (TiHAp) were synthesized from a mixture of a titanium alkoxide solution and dissolution products of a Moroccan natural phosphate. The simultaneous gelation and precipitation processes occurring at room temperature led to the formation of TiHAp nanocomposites. X-ray diffraction results indicated that hydroxyapatite and anatase (TiO2) were the major crystalline phases. The specific surface area of the nanocomposites increased with the TiO2 content. Resulting TiHAp powders were assessed for the removal of the patent blue V dye from water. Kinetic experiments suggested that a sequence of adsorption and photodegradation is responsible for discoloration of dye solutions. These results suggest that such hydroxyapatite/titania nanocomposites constitute attractive low-cost materials for the removal of dyes from industrial textile effluent.
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Affiliation(s)
- C. El Bekkali
- Laboratoire de Chimie Physique Générale, Faculté des Sciences, Université Mohammed V, Av. Ibn Batouta, B.P. 1014 Rabat, Morocco
| | - H. Bouyarmane
- Laboratoire de Chimie Physique Générale, Faculté des Sciences, Université Mohammed V, Av. Ibn Batouta, B.P. 1014 Rabat, Morocco
| | - S. Saoiabi
- Laboratoire de Chimie Physique Générale, Faculté des Sciences, Université Mohammed V, Av. Ibn Batouta, B.P. 1014 Rabat, Morocco
| | - M. El Karbane
- Laboratoire National du Contrôle des Médicaments, Rue Lamfaddal Cherkaoui, B.P. 6206 Rabat, Morocco
| | - A. Rami
- Laboratoire National du Contrôle des Médicaments, Rue Lamfaddal Cherkaoui, B.P. 6206 Rabat, Morocco
| | - A. Saoiabi
- Laboratoire de Chimie Physique Générale, Faculté des Sciences, Université Mohammed V, Av. Ibn Batouta, B.P. 1014 Rabat, Morocco
| | - M. Boujtita
- Chimie Interdisciplinarité: Synthèse, Analyse, Modélisation CNRS (CEISAM), Faculté des Sciences et Techniques, Université de Nantes – UBL, B.P. 92208, 44322 Nantes Cedex 03, France
| | - A. Laghzizil
- Laboratoire de Chimie Physique Générale, Faculté des Sciences, Université Mohammed V, Av. Ibn Batouta, B.P. 1014 Rabat, Morocco
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Maranhão MVM, da Nóbrega DKA, Anunciação CEC, Maia BDAB, Mariano PVD. Allergic reaction to patent blue dye in breast surgery - case report. Braz J Anesthesiol 2016; 66:433-6. [PMID: 27343798 DOI: 10.1016/j.bjane.2014.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 02/12/2014] [Indexed: 10/21/2022] Open
Abstract
We present a case of allergic reaction to patent blue in a patient who underwent excision of sentinel lymph node associated with segmental breast resection. About 20min after the dye injection, the patient developed hypotension (BP=70×30mmHg) associated with increased heart frequency. The patient was treated successfully with decreased inspired fraction of inhaled anesthetic and fluid replacement. At the end of the procedure, she presented with bluish urticarial-like plaques on the head, neck, upper limbs, and trunk; hydrocortisone was then used. The patient recovered uneventfully and was discharged from the PACU 2h after the end of surgery without skin changes, and was discharged from hospital on the morning after surgery. The incidence of allergic reactions with the use of patent blue is far superior to the hypersensitivity reactions seen with anesthetic and adjuvant drugs. Therefore, the anesthesiologist must be aware of cardiovascular instability associated with skin changes during the use of patent blue, for early diagnosis and appropriate treatment of this hypersensitivity reaction to this dye.
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Laukaityte E, Bruyère M, Bull A, Benhamou D. Accidental injection of patent blue dye during gynaecological surgery: Lack of knowledge constitutes a system error. Anaesth Crit Care Pain Med 2015; 34:57-60. [PMID: 25829317 DOI: 10.1016/j.accpm.2014.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 08/13/2014] [Indexed: 11/15/2022]
Abstract
The authors report a case in which an intravenous injection of Patent Blue V dye instead of Indigo Carmine was given during routine gynaecological surgery. The patient presented with temporary arterial (spurious) desaturation and skin discoloration over a 48-hour period. Pharmacological differences between these dyes are described. Root cause analysis based on the ALARM (Association of Litigation and Risk Management) model is presented. The authors emphasise that use of this model should not be limited solely to describing and correcting well known systems errors such as working conditions or teamwork and communication. Furthermore, they conclude that insufficient knowledge must also be recognised as a systems error and as such should be sought out and corrected using similar strategies to those used to discover other contributory factors, without allocation of blame to any individual.
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Affiliation(s)
- Edita Laukaityte
- Department of Anaesthesia and Intensive Care Medicine, hôpitaux universitaires Paris-Sud, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France
| | - Marie Bruyère
- Department of Anaesthesia and Intensive Care Medicine, hôpitaux universitaires Paris-Sud, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France
| | - Amanda Bull
- Department of Anaesthesia and Intensive Care Medicine, hôpitaux universitaires Paris-Sud, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France
| | - Dan Benhamou
- Department of Anaesthesia and Intensive Care Medicine, hôpitaux universitaires Paris-Sud, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France.
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Maranhão MVM, Nóbrega DKAD, Anunciação CEC, Maia BDAB, Mariano PVD. [Allergic reaction to patent blue dye in breast surgery - case report]. Rev Bras Anestesiol 2014; 66:433-6. [PMID: 25458838 DOI: 10.1016/j.bjan.2014.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 02/12/2014] [Indexed: 10/24/2022] Open
Abstract
We present a case of allergic reaction to patent blue in a patient who underwent excision of sentinel lymph node associated with segmental breast resection. About 20minutes after the dye injection, the patient developed hypotension (BP=70×30mmHg) associated with increased heart frequency. The patient was treated successfully with decreased inspired fraction of inhaled anesthetic and fluid replacement. At the end of the procedure, she presented with bluish urticarial - like plaques on the head, neck, upper limbs, and trunk; hydrocortisone was then used. The patient recovered uneventfully and was discharged from the PACU two hours after the end of surgery without skin changes, and was discharged from hospital on the morning after surgery. The incidence of allergic reactions with the use of patent blue is far superior to the hypersensitivity reactions seen with anesthetic and adjuvant drugs. Therefore, the anesthesiologist must be aware of cardiovascular instability associated with skin changes during the use of patent blue, for early diagnosis and appropriate treatment of this hypersensitivity reaction to this dye.
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Inoue T, Nishi T, Nakano Y, Nishimae A, Sawai Y, Yamasaki M, Inaji H. Axillary lymph node recurrence after sentinel lymph node biopsy performed using a combination of indocyanine green fluorescence and the blue dye method in early breast cancer. Breast Cancer 2014; 23:295-300. [PMID: 25348937 DOI: 10.1007/s12282-014-0573-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 10/14/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND There is limited information on indocyanine green (ICG) fluorescence and blue dye for detecting sentinel lymph node (SLN) in early breast cancer. A retrospective study was conducted to assess the feasibility of an SLN biopsy using the combination of ICG fluorescence and the blue dye method. METHODS Seven hundred and fourteen patients with clinically node-negative breast cancer were included in this study. They underwent SLN biopsy using a combination of ICG fluorescence and the blue dye method from March 2007 to February 2014. The ICG (a fluorescence-emitting source) and patent blue (the blue dye) were injected into the patients' subareolar region. The removed lymph nodes that had ICG fluorescence and/or blue dye uptake were defined as SLNs. The results of the SLN biopsies and follow-up results of patients who underwent SLN biopsy alone were investigated. RESULTS In 711 out of 714 patients, SLNs were identified by a combination of ICG fluorescence and the blue dye method (detection rate, 99.6 %). The average number of SLNs was 2.4 (range 1-7), and the average number of resected swollen para-SLNs was 0.4 (range 0-5). Ninety-nine patients with an SLN and/or para-SLN involvement during the intraoperative pathological diagnosis underwent axillary lymph node resection (ALND). In addition, two of three patients whose SLN was not identified also underwent ALND. In 46 of 101 patients with an ALND, non-SLN involvement was not found. Follow-up results were analyzed in 464 patients with invasive carcinoma excluding those with ductal carcinoma in situ (n = 148) and those who underwent ALND (n = 101). During the follow-up period (range 4.4-87.7 months; median, 38 months), two patients (0.4 %) developed axillary lymph node recurrence. They were successfully salvaged, and to date, no further locoregional recurrence has been observed. CONCLUSIONS A high rate of SLN detection and low rate of axillary lymph node recurrence were confirmed by an SLN biopsy using a combination of ICG fluorescence and the blue dye method. Therefore, it is suggested that this method may replace the combination of dye and radioisotope methods.
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Affiliation(s)
- Tomoo Inoue
- Department of Breast Surgery, Kaizuka City Hospital, 3-10-20, Hori, Kaizuka, Osaka, 597-0015, Japan.
| | - Toshio Nishi
- Department of Breast Surgery, Kaizuka City Hospital, 3-10-20, Hori, Kaizuka, Osaka, 597-0015, Japan
| | - Yoshiaki Nakano
- Department of Breast Surgery, Kaizuka City Hospital, 3-10-20, Hori, Kaizuka, Osaka, 597-0015, Japan
| | - Ayaka Nishimae
- Department of Breast Surgery, Kaizuka City Hospital, 3-10-20, Hori, Kaizuka, Osaka, 597-0015, Japan
| | - Yuka Sawai
- Department of Diagnostic Radiology, Kaizuka City Hospital, Kaizuka, Osaka, Japan
| | - Masaru Yamasaki
- Department of Pathology, Kaizuka City Hospital, Kaizuka, Osaka, Japan
| | - Hideo Inaji
- Department of Breast Surgery, Kaizuka City Hospital, 3-10-20, Hori, Kaizuka, Osaka, 597-0015, Japan
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Gumus M, Gumus H, Jones SE, Jones PA, Sever AR, Weeks J. How long will I be blue? Prolonged skin staining following sentinel lymph node biopsy using intradermal patent blue dye. ACTA ACUST UNITED AC 2014; 8:199-202. [PMID: 24415970 DOI: 10.1159/000352092] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Blue dye used for sentinel lymph node biopsy (SLNB) in breast cancer patients may cause prolonged skin discoloration at the site of injection. The aim of this study was to assess the duration of such skin discoloration. PATIENTS AND METHODS 236 consecutive patients who had undergone breast conserving surgery and SLNB for breast cancer were reviewed prospectively from January 2007 to December 2009. RESULTS Of the 236 patients, 2 had undergone bilateral surgery, and 41 had been examined in consecutive yearly reviews. Blue discoloration remained visible at the injection site after 12, 24, and > 36 months in 36.5, 23.6, and 8.6% of the patients, respectively. CONCLUSION The use of patent blue for identification of the sentinel lymph node in patients undergoing breast cancer surgery may result in prolonged discoloration of the skin at the injection site.
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Affiliation(s)
- Metehan Gumus
- Department of General Surgery, Dicle University, Medical School, Yenişehir, Diyarbakır, Turkey
| | - Hatice Gumus
- Department of Radiology, Dicle University, Medical School, Yenişehir, Diyarbakır, Turkey
| | - Sue E Jones
- Department of Surgery, Maidstone Hospital, Hermitage Lane, Maidstone, United Kingdom
| | - Peter A Jones
- Department of Surgery, Maidstone Hospital, Hermitage Lane, Maidstone, United Kingdom
| | - Ali R Sever
- Department of Radiology, Maidstone Hospital, Hermitage Lane, Maidstone, United Kingdom
| | - Jennifer Weeks
- Department of Radiology, Maidstone Hospital, Hermitage Lane, Maidstone, United Kingdom
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