Online ISSN: 2515-8260

Keywords : methylene blue

Sentinel Lymph node biopsy in Carcinoma Stomach

Y.VKeshav Prasad, Shruthi Prabhu, A N Bhargava Vyas, Rajat Choudhari,A N Bhargava Vyas .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 92-99

Background:Surgery is the mainstay of treatment in gastric carcinoma management with a longstanding controversy regarding the extent of lymphadenectomy. Recent studies have shown 88%sensitivity of Sentinel Node biopsy for patients with gastric cancer. There is a need for evaluation of this technique using cost effective alternative of methylene blue dye.
Methods: This was a prospective study which included all adults with diagnosis of carcinoma stomach planned for surgical resection. Intra-operatively, methylene blue dye was injected into the tumor and the stained lymph nodes were removed along with other visibly enlarged nodes.
Results: A total of 32 subjects were recruited in the study period. Mean age of the patients was 56.59 (±12.02) years. Among all the specimens a total of 127 (35%) of 361 lymph nodes were found to be stained with methylene blue dye. Metastatic deposits were found in 132 of 361 lymph nodes. Bivariate analysis showed 79.52% of the lymph nodes stained with methylene blue were positive for metastases in contrast to 13.2% among those that remained unstained (p 0.001).
Conclusion:Sentinel lymph node mapping using methylene blue is a simple, cost and resource effective technique in all cases of gastric carcinoma undergoing resection, especially in early gastric carcinoma.

Recurrent laryngeal nerve identification in thyroidectomy by intraoperative staining with methylene blue

Ahmed Emad Eldeen Sebaey; Alaa Mohamed Khalil; Mohamed Mahmoud Elkilany; Ramadan Mahmoud Ali

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 644-649

Background: Unrecognized transection of the recurrent laryngeal nerve (RLN) or its motor branch could result in an unexpected permanent palsy. So, for a safe thyroid operation, intraoperative assurance of anatomical and functional RLN integrity is a necessity. Aim of work: To evaluate the recognition and protection of RLN by staining the RLN intraoperatively with methylene blue (MB) in one side and comparing it with the identification alone in the other side visually during total thyroidectomy. Subjects and methods: A case control study (retrospective study) carried out in the department of surgical oncology Zagazig university hospitals and Ismailia teaching oncology hospital during the period from November 2018 to August 2019. The study included 112 patients with bilateral thyroid disease who will do total thyroidectomy. The patients were subdivided into two groups depending on the MB use. Complete history taking was taken from all subjects. General examination of all body systems and local examination of the neck were done. We also did full lab investigations, neck U/S then the operations were performed. Results: We detected transient vocal cord palsy 10 sides (8.6%) of visual  identification alone, while in MB sides no case was detected with the same lesion. Conclusion: Recognition of RLN intraoperatively by MB staining is cheap and widely available technique and can decrease the stress during thyroidectomy, especially when Intra Operative Nerve Monitoring (IONM) is absent.