Intraoperative tumor localization with surgeon-performed ultrasound-guided needle dye injection.

Objectives: To describe our technique and initial experience of intraoperative tumor localization with surgeon-performed ultrasound-guided needle dye injection. Study Design: Prospective case series. Technique description. Methods: Using surgeon-performed ultrasonography (SP-US), 20 tumors (lymph no...

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Publicado en:Laryngoscope Vol. 121; no. 8; pp. 1651 - 1656
Autores principales: Ryan WR, Orloff LA, Ryan, William R, Orloff, Lisa A
Formato: research Journal Article
Publicado: Wiley-Blackwell Aug2011
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
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        10.1002/lary.21774
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        atl: Intraoperative tumor localization with surgeon-performed ultrasound-guided needle dye injection.
      aug:
        au:
          Ryan WR
          Orloff LA
          Ryan, William R
          Orloff, Lisa A
        affil: Division of Head and Neck and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California 94115, USA
      sug:
        subj:
          Dyes Diagnostic Use
          Head and Neck Neoplasms Diagnosis
          Head and Neck Neoplasms Surgery
          Methylene Blue Diagnostic Use
          Ultrasonography
          Adult
          Aged
          Head and Neck Neoplasms Ultrasonography
          Injections
          Intraoperative Period
          Methylene Blue Administration and Dosage
          Middle Age
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
      ab: Objectives: To describe our technique and initial experience of intraoperative tumor localization with surgeon-performed ultrasound-guided needle dye injection. Study Design: Prospective case series. Technique description. Methods: Using surgeon-performed ultrasonography (SP-US), 20 tumors (lymph node metastases of papillary thyroid carcinoma [15], Hurthle cell carcinoma [2], medullary thyroid carcinoma [1], and lymphoma [1], and a parathyroid adenoma [1]) were localized in 13 patients. With ultrasound guidance, 0.1 mL of 1% methylene blue dye was injected into each targeted tumor. The blue color in contrast helped guide the dissection. Sixteen of 20 (80%) of dissections were revision cases through scar. Results: Using SP-US and US-guided injection with blue dye, 20 of 20 (100%) of cases were successful in retrieving the target tumor with no inadvertent nerve injuries (nerves at risk in scar: recurrent laryngeal [12], phrenic [3], vagus [3], and sympathetic chain [3]). Dye injection adds 5 to 10 minutes of time prior to incision. Injections appeared to increase visual differentiation of tissue, save time during dissection, particularly during revision dissections, and help ensure successful target retrieval. Injection into a parathyroid adenoma resulted in an overabundance of blue dye in nontumor tissue. Conclusions: Surgeon-performed ultrasound guided needle dye injection is particularly helpful in directing the surgeon to the appropriate area for tumor resection in fibrotic areas and thereby possibly reducing surgical time, sampling error, and morbidity. A lower concentration or a different dye may be more helpful for parathyroid adenomas. Further study on this technique is needed and is under way with a larger group of patients. Educational Objective: At the conclusion of this manuscript, the participants should be able to understand the technique and advantages of intraoperative tumor localization with surgeon-performed ultrasound-guided needle blue dye injection.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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