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Article

Using low concentration sodium hypochlorite to improve colorectal surgical specimen lymph node harvest

  • Authors:
    • Nanrong Yu
    • Haiying Liu
    • Jianchang Li
    • Shicai Chen
  • View Affiliations / Copyright

    Affiliations: Department of Gastrointestinal Tumor Surgery, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong 510095, P.R. China
  • Pages: 519-524
    |
    Published online on: March 19, 2020
       https://doi.org/10.3892/mco.2020.2018
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Abstract

Lymph node (LN) retrieval is a critical procedure to determine the pathological stage and adjuvant therapy for colorectal cancer. The present study aimed to recommend a novel method by using sodium hypochlorite to improve colorectal surgical specimen LN harvest. Dissolving time of mesenteric LNs and fat tissue was firstly investigated in different concentrations of sodium hypochlorite. In the sodium hypochlorite group, 65 patients with colorectal cancer who underwent curative surgery were included. After standard manual gross dissection, the mesenteric tissue was subsequently immersed in 1% sodium hypochlorite for ~30 min, and then manual dissection was again applied for additional LN harvest. In the manual method group, 68 patients with colorectal cancer were selected and only manual dissection method was applied for LN harvest. The number of LNs in both groups were recorded for each case. Sodium hypochlorite could dissolve fat tissue significantly faster than LNs and the low concentration sodium hypochlorite had the maximum dissolving time difference between fat tissue and LNs (P<0.001). After sodium hypochlorite treatment, more LNs were identified when compared with the manual dissection method (28.2±12.1 vs. 16.5±8.7; P=0.010), whereas the number of positive LNs had no significant statistical difference between the two groups (P=0.181). After sodium hypochlorite immersion, 818 additional LNs (12.5±4.8 per case) were identified and LNs ≤2 mm were 58.4% (478/818). Moreover, 16 additional metastatic LNs were found in 10 patients. A total of 7 of them were upstaged, including 2 initially N0 cases. Using sodium hypochlorite at low concentrations may be the most simple, rapid, cost‑saving, nontoxic and effective technique to improve LN harvest in colorectal carcinoma specimens so far. This method should be used routinely regardless of whether the number of LNs is <12 or not.
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Copy and paste a formatted citation
Spandidos Publications style
Yu N, Liu H, Li J and Chen S: Using low concentration sodium hypochlorite to improve colorectal surgical specimen lymph node harvest. Mol Clin Oncol 12: 519-524, 2020.
APA
Yu, N., Liu, H., Li, J., & Chen, S. (2020). Using low concentration sodium hypochlorite to improve colorectal surgical specimen lymph node harvest. Molecular and Clinical Oncology, 12, 519-524. https://doi.org/10.3892/mco.2020.2018
MLA
Yu, N., Liu, H., Li, J., Chen, S."Using low concentration sodium hypochlorite to improve colorectal surgical specimen lymph node harvest". Molecular and Clinical Oncology 12.6 (2020): 519-524.
Chicago
Yu, N., Liu, H., Li, J., Chen, S."Using low concentration sodium hypochlorite to improve colorectal surgical specimen lymph node harvest". Molecular and Clinical Oncology 12, no. 6 (2020): 519-524. https://doi.org/10.3892/mco.2020.2018
Copy and paste a formatted citation
x
Spandidos Publications style
Yu N, Liu H, Li J and Chen S: Using low concentration sodium hypochlorite to improve colorectal surgical specimen lymph node harvest. Mol Clin Oncol 12: 519-524, 2020.
APA
Yu, N., Liu, H., Li, J., & Chen, S. (2020). Using low concentration sodium hypochlorite to improve colorectal surgical specimen lymph node harvest. Molecular and Clinical Oncology, 12, 519-524. https://doi.org/10.3892/mco.2020.2018
MLA
Yu, N., Liu, H., Li, J., Chen, S."Using low concentration sodium hypochlorite to improve colorectal surgical specimen lymph node harvest". Molecular and Clinical Oncology 12.6 (2020): 519-524.
Chicago
Yu, N., Liu, H., Li, J., Chen, S."Using low concentration sodium hypochlorite to improve colorectal surgical specimen lymph node harvest". Molecular and Clinical Oncology 12, no. 6 (2020): 519-524. https://doi.org/10.3892/mco.2020.2018
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