Abstract
Simple SummaryThe evaluation of regional/sentinel lymph nodes (LN) plays an important prognostic role and assists the clinical decision making in canine cancer patients; thus, surgeons are frequently asked to perform regional/sentinel lymphadenectomies together with management of the primary tumor sites, even when these are non-palpable and/or normal size LN. Several techniques have been described to localized regional/sentinel LN in a pre-surgical setting. The wire-guided localization is commonly used to localize non-palpable breast masses in women, with the aim to reduce surgical dissection and excision of unnecessary tissue and to reduce surgical time. This study describes the use of an ultrasound-guided hook-wire localization method to facilitate intraoperative localization of non-palpable superficial inguinal LN. The results of the present study suggest that this method is safe and effective and may allow a high rate of successful superficial inguinal LN excisions in dogs.The evaluation of loco-regional lymph nodes (LN) plays an important prognostic role and assists the clinical decision making in canine cancer patients. Excision of non-palpable LN can be challenging. The aim of the study was to evaluate surgical time, successful excision rate and surgical complications associated with the use of an ultrasound-guided hook-wire (UGHW) LN localization method for non-palpable superficial inguinal LN (SILN) in dogs. Dogs that presented for excision of non-palpable SILN, performed with the aid of an UGHW placement, were enrolled. Information including signalment, SILN width, UGHW placement and surgical procedure time, hook-wire position, successful excision and intra- and post-operative complications were reviewed. Seventeen dogs were enrolled. Median LN width was 3 mm (range 2–11). Median time of preoperative UGHW placement and surgical LN excision was 8 min and 15 min, respectively. Successful SILN excision was achieved in all cases. Two minor intra-operative (hook migration and wire fragmentation) and one minor post-operative complications (seroma) were observed. No major intraoperative or post-operative complications occurred. The UGHW LN localization method is safe and effective and may allow a high rate of successful SILN excisions in dogs. This method has the potential to facilitate LN excision for other superficial LN locations.
Highlights
The status of loco-regional lymph nodes (LN) in dogs with malignancies plays a pivotal role in clinical decision making [1,2], and the treatment of metastatic LN is associated with longer survival times in dogs diagnosed with mast cell tumor and anal sac apocrine gland adenocarcinoma [3,4,5]
In this study we demonstrated that the ultrasound-guided hook-wire (UGHW) is a safe and effective localization method for the excision of non-palpable superficial inguinal lymph nodes (SILN)
The UGHW localization method used in the present study allowed the excision of SILN in 91% of the cases with only two minor intra-operative and one short-term post-operative complications making the use of the UGHW for the excision of SILN a suitable method for a successful excision
Summary
The status of loco-regional lymph nodes (LN) in dogs with malignancies plays a pivotal role in clinical decision making [1,2], and the treatment of metastatic LN is associated with longer survival times in dogs diagnosed with mast cell tumor and anal sac apocrine gland adenocarcinoma [3,4,5].Nowadays, surgeons are more frequently asked to remove one or more non-palpable LN to better characterize malignancies such as head cancers, cutaneous mast cell tumor and oral melanoma [1,2,6].Bilateral mandibular and medial retropharyngeal lymphadenectomy have been suggested to provide more accurate information in dogs with head cancers, being able to unmask metastatic disease in normal sized LN with minor post-operative complications [1,7]; little is known on morbidity and success of lymphadenectomy of non-palpable peripheral LN at other sites.In dogs, superficial inguinal lymph nodes (SILN) are located deep to the inguinal mammary gland in females and at approximatively the level of the bulbus glandis in males [8]. The status of loco-regional lymph nodes (LN) in dogs with malignancies plays a pivotal role in clinical decision making [1,2], and the treatment of metastatic LN is associated with longer survival times in dogs diagnosed with mast cell tumor and anal sac apocrine gland adenocarcinoma [3,4,5]. Surgeons are more frequently asked to remove one or more non-palpable LN to better characterize malignancies such as head cancers, cutaneous mast cell tumor and oral melanoma [1,2,6]. Bilateral mandibular and medial retropharyngeal lymphadenectomy have been suggested to provide more accurate information in dogs with head cancers, being able to unmask metastatic disease in normal sized LN with minor post-operative complications [1,7]; little is known on morbidity and success of lymphadenectomy of non-palpable peripheral LN at other sites. Nodal localization can be time consuming, requiring extensive tissue dissection
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