VEILND (Video Endoscopic Inguinal Lymph Node Dissection) with Florescence Indocyanine Green (ICG): A Novel Technique to Identify the Sentinel Lymph Node in Men with ≥pT1G2 and cN0 Penile Cancer

Introduction. In men with ≥pT1G2 cN0, penile cancer lymph node sampling is recommended with either (1) scintigraphically labelled Dynamic sentinel lymph node biopsy (DSLNB) or (2) modified inguinal lymph node dissection (MILND). Although DSLNB is a minimally invasive technique, the false negative ra...

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Autores principales:	Milan Hora, Ivan Trávníček, Štěpánka Nykodýmová, Jiří Ferda, Denisa Kacerovská, Květoslava Michalová, Ondřej Hes, Suks Minhas
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi-Wiley 2021
Materias:	Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/7127ee424b1a4159a559f201c19ca74a
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spelling	oai:doaj.org-article:7127ee424b1a4159a559f201c19ca74a2021-11-08T02:35:28ZVEILND (Video Endoscopic Inguinal Lymph Node Dissection) with Florescence Indocyanine Green (ICG): A Novel Technique to Identify the Sentinel Lymph Node in Men with ≥pT1G2 and cN0 Penile Cancer1555-431710.1155/2021/5575730https://doaj.org/article/7127ee424b1a4159a559f201c19ca74a2021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/5575730https://doaj.org/toc/1555-4317Introduction. In men with ≥pT1G2 cN0, penile cancer lymph node sampling is recommended with either (1) scintigraphically labelled Dynamic sentinel lymph node biopsy (DSLNB) or (2) modified inguinal lymph node dissection (MILND). Although DSLNB is a minimally invasive technique, the false negative rate can be about 10%, and a further operative procedure is required if positive. Open MILND is a diagnostic and therapeutic option but has a much higher morbidity. A potential compromise is the technique of LND-VEILND (video endoscopic inguinal LND) that can be combined with ICG florescence marking of sentinel lymph node (SLN). We present a pilot study of ICG-VEILND. The aim was to validate the applicability of a combination ICG marking of SLN in VEILND (to increase probability to excise SLN) and determine the optimal timing and dosage of ICG. Materials and Methods. 15 patients with VEILND (24 groins) underwent ICG application with fluorescence near-infrared (NIR 803⟶830 nm) detection. ICG is applied subcutaneously adjacent to the penile cancer or residual stump of penis or suprapubic region (in a history of total penectomy: 5 cases). The dose of 1.25 mg (ICG) was applied in one case with invisible SLN, the dose of 2.5 mg in 1 mL in 8 cases, and 5 mg in the remaining 6 patients (10 groins). Results. Failure of marking SLN with ICG occurred in 25.0% of cases (6/24): due to application of 1.25 mg ICG, extensive metastasis to SLN, in 4 cases, the cause was unknown (16.7%, 4/24). In the short follow-up period, no local recurrence was seen in the pN0 ICG group. Conclusion. Fluorescence infrared image with ICG dye increases the probability of removal of the SLN during VEILND. The dose of ICG is 2.5 (5) mg diluted in 1 ml and can be applied preoperatively even in the suprapubic region in men with a history of total penectomy, with an unexplainable failure of ICG marking in 16.7%.Milan HoraIvan TrávníčekŠtěpánka NykodýmováJiří FerdaDenisa KacerovskáKvětoslava MichalováOndřej HesSuks MinhasHindawi-WileyarticleMedical technologyR855-855.5ENContrast Media & Molecular Imaging, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical technology R855-855.5
spellingShingle	Medical technology R855-855.5 Milan Hora Ivan Trávníček Štěpánka Nykodýmová Jiří Ferda Denisa Kacerovská Květoslava Michalová Ondřej Hes Suks Minhas VEILND (Video Endoscopic Inguinal Lymph Node Dissection) with Florescence Indocyanine Green (ICG): A Novel Technique to Identify the Sentinel Lymph Node in Men with ≥pT1G2 and cN0 Penile Cancer
description	Introduction. In men with ≥pT1G2 cN0, penile cancer lymph node sampling is recommended with either (1) scintigraphically labelled Dynamic sentinel lymph node biopsy (DSLNB) or (2) modified inguinal lymph node dissection (MILND). Although DSLNB is a minimally invasive technique, the false negative rate can be about 10%, and a further operative procedure is required if positive. Open MILND is a diagnostic and therapeutic option but has a much higher morbidity. A potential compromise is the technique of LND-VEILND (video endoscopic inguinal LND) that can be combined with ICG florescence marking of sentinel lymph node (SLN). We present a pilot study of ICG-VEILND. The aim was to validate the applicability of a combination ICG marking of SLN in VEILND (to increase probability to excise SLN) and determine the optimal timing and dosage of ICG. Materials and Methods. 15 patients with VEILND (24 groins) underwent ICG application with fluorescence near-infrared (NIR 803⟶830 nm) detection. ICG is applied subcutaneously adjacent to the penile cancer or residual stump of penis or suprapubic region (in a history of total penectomy: 5 cases). The dose of 1.25 mg (ICG) was applied in one case with invisible SLN, the dose of 2.5 mg in 1 mL in 8 cases, and 5 mg in the remaining 6 patients (10 groins). Results. Failure of marking SLN with ICG occurred in 25.0% of cases (6/24): due to application of 1.25 mg ICG, extensive metastasis to SLN, in 4 cases, the cause was unknown (16.7%, 4/24). In the short follow-up period, no local recurrence was seen in the pN0 ICG group. Conclusion. Fluorescence infrared image with ICG dye increases the probability of removal of the SLN during VEILND. The dose of ICG is 2.5 (5) mg diluted in 1 ml and can be applied preoperatively even in the suprapubic region in men with a history of total penectomy, with an unexplainable failure of ICG marking in 16.7%.
format	article
author	Milan Hora Ivan Trávníček Štěpánka Nykodýmová Jiří Ferda Denisa Kacerovská Květoslava Michalová Ondřej Hes Suks Minhas
author_facet	Milan Hora Ivan Trávníček Štěpánka Nykodýmová Jiří Ferda Denisa Kacerovská Květoslava Michalová Ondřej Hes Suks Minhas
author_sort	Milan Hora
title	VEILND (Video Endoscopic Inguinal Lymph Node Dissection) with Florescence Indocyanine Green (ICG): A Novel Technique to Identify the Sentinel Lymph Node in Men with ≥pT1G2 and cN0 Penile Cancer
title_short	VEILND (Video Endoscopic Inguinal Lymph Node Dissection) with Florescence Indocyanine Green (ICG): A Novel Technique to Identify the Sentinel Lymph Node in Men with ≥pT1G2 and cN0 Penile Cancer
title_full	VEILND (Video Endoscopic Inguinal Lymph Node Dissection) with Florescence Indocyanine Green (ICG): A Novel Technique to Identify the Sentinel Lymph Node in Men with ≥pT1G2 and cN0 Penile Cancer
title_fullStr	VEILND (Video Endoscopic Inguinal Lymph Node Dissection) with Florescence Indocyanine Green (ICG): A Novel Technique to Identify the Sentinel Lymph Node in Men with ≥pT1G2 and cN0 Penile Cancer
title_full_unstemmed	VEILND (Video Endoscopic Inguinal Lymph Node Dissection) with Florescence Indocyanine Green (ICG): A Novel Technique to Identify the Sentinel Lymph Node in Men with ≥pT1G2 and cN0 Penile Cancer
title_sort	veilnd (video endoscopic inguinal lymph node dissection) with florescence indocyanine green (icg): a novel technique to identify the sentinel lymph node in men with ≥pt1g2 and cn0 penile cancer
publisher	Hindawi-Wiley
publishDate	2021
url	https://doaj.org/article/7127ee424b1a4159a559f201c19ca74a
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VEILND (Video Endoscopic Inguinal Lymph Node Dissection) with Florescence Indocyanine Green (ICG): A Novel Technique to Identify the Sentinel Lymph Node in Men with ≥pT1G2 and cN0 Penile Cancer

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