IDENTIFICATION OF PELVIC LYMPH NODES WITH CHLOROPHYLLIN AFTER INJECTION INTO THE UTERINE CERVIX: AN EXPERIMENTAL AND CLINICAL STUDY

Abstract

We investigated the value of staining retroperitoneal lymph nodes with chlorophyllin innormal dogs and in women with malignant uterine tumors undergoing lymphadenectomy. Indogs, after 0.3% chlorophyllin (sodium copper chlorophyllin) was injected into the canineuterus, the concentration of dye in the bloodstream was measured with a spectrophotometer andsections of stained retroperitoneal lymph nodes were examined using light and electronmicroscopy. The highest blood levels were detected at 4 hrs and nearly all of the chlorophyllinwas gone from the bloodstream by 18 hrs but was retained in and nodal macrophages for at least4 days. No morphological changes were founded in the excised lymph nodes. Twenty-fourpatients with cervical carcinoma and 20 patients with endometrial carcinoma undergoingradical hysterectomy and lymphadenectomy were divided into a lymphatic coloration group (23patients) and a non-coloration (control) group (21 patients). In the lymphatic coloration group(0.3% chlorophyllin) was injected into the cervix 5 days before elective lymphadenectomy. Therewere no complications attributed to injection of the chlorophyllin. The number of dissectedlymph nodes in the coloration group were greater than the control group (p<0.01) and the timeof operation was shorter (p<0.01). These results suggest that chlorophyllin is safe and facilitatesidentification of retroperitoneal lymph nodes, allows more complete nodal excision and shortensthe time of operation in patients undergoing radical hysterectomy with lymphadenectomy.