Sentinel lymph node (SLN) mapping (M) in colon cancer (CCa) by da Vinci robotic system (DRS): First pilot study.

Authors

null

Sukamal Saha

McLaren Regional Medical Center, Michigan State Un

Sukamal Saha , Alpesh Korant , Benjamin Abadeer , Andrew Gomez-Seoane , Mohammed Shaik , Madhumitha Krishnamoorthy , Sunil Kaushal , B. K. Ganatra , David Wiese

Organizations

McLaren Regional Medical Center, Michigan State Un, Hurley Medical Center, Michigan State University

Research Funding

No funding sources reported

Background: SLNM in CCa has been established as an aid to the pathologist to identify the nodes most likely to harbor micrometastasis. The technique has been well- established by in vivo and ex vivo technique. No such technique has been described by DRS in CCa. Hence, a pilot study was undertaken to identify if SLNM can be performed by DRS during robotically assisted colectomy as in open cases. Methods: Patients (Pts) with CCa were randomly selected for either robotic or open surgery. During each case, 1% methylene blue dye was injected in vivo subserosally around the tumor. Standard oncologic operations were done in each case. The first 1-4 blue nodes near the tumor were tagged with suture as SLNs. Data was collected for demographics, tumor pathology and peri-operative events. Results: There were a total of 11 consecutive robotic pts and 15 open pts. The data was compared between the robotic vs open groups as follows: Primary sites including Cecum (1 vs 3), Ascending Colon (3 vs 4), Transverse Colon (4 vs 5), Sigmoid Colon (2 vs 3); Average number of LNs (18.5 vs 17.6); Average number of SLNs (3.3 vs 3.0), and nodal positivity (50% vs 50%). The success rate was 100% in each group. Conclusions: There are great similarities for SLNM between robotic and open surgeries for CCa in regards to success rate, nodal harvest, SLNs, and nodal positivity. Hence, SLNM should be pursued when robotic surgeries are performed for CCa pts as in open cases.

DRS (N = 10) Open procedure (N = 15)
Sex (female:male) 4:6 11:4
Age (yrs) 64.2 (44-81) 65.5 (36-80)
Body mass index 28.8 (21-40) 28.2 (18-48)
Location
Cecum 1 3
Ascending 3 4
Transverse 4 5
Sigmoid 2 3
Grade
T0, Tis, TA, TVA 2 1
I 2 2
II 4 9
III 2 3
Nodal positivity
Tumor size (cm) 4.32 (1.5-8) 4.2 (1-9)
Avg. total no. of lymph nodes 18.5 (9-36) 17.6 (8-36)
Avg. no. of sentinel lymph lodes 3.3 (1-5) 3 (1-7)
Nodal positivity* 50% 50%
AJCC staging
0 2 1
I 1 3
II 3 4
III 2 4
IV 2 3
Peri-opertive events
Operative room time (Min) 290 (234-397) 207 (94-286)
Estimated blood loss (mL) 165 (100-300) 190 (100-600)
Intra-operative complications 0 0
Immediate complications 2 3
Late complications 0 0
2nd operation or intervention for complications 0 1
Conversion to open surgery 0 N/A
Length of hospital stay (days) 8.5 (6-16) 7.5 (3-14)

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Abstract Details

Meeting

2013 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

General Poster Session C: Cancers of the Colon and Rectum

Track

Cancers of the Colon, Rectum, and Anus

Sub Track

Multidisciplinary Treatment

Citation

J Clin Oncol 31, 2013 (suppl 4; abstr589)

DOI

10.1200/jco.2013.31.4_suppl.589

Abstract #

589

Poster Bd #

E37

Abstract Disclosures

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