Increased post-operative complications with methylene blue versus lymphazurin in sentinel lymph node biopsies for skin cancers
Article first published online: 28 DEC 2010
Copyright © 2010 Wiley-Liss, Inc.
Journal of Surgical Oncology
Volume 103, Issue 5, pages 421–425, 1 April 2011
How to Cite
Neves, R. I., Reynolds, B. Q., Hazard, S. W., Saunders, B. and Mackay, D. R. (2011), Increased post-operative complications with methylene blue versus lymphazurin in sentinel lymph node biopsies for skin cancers. J. Surg. Oncol., 103: 421–425. doi: 10.1002/jso.21845
- Issue published online: 11 MAR 2011
- Article first published online: 28 DEC 2010
- Manuscript Accepted: 29 NOV 2010
- Manuscript Received: 16 JUN 2010
- sentinel lymph node biopsy;
- skin cancers;
- blue dye;
Sentinel lymph node biopsy (SNLB) is the standard of care in staging of melanoma and other skin cancers. Early studies used lymphazurin (LZ) for SLNB. A national shortage of LZ promoted methylene blue (MB) as an alternate stain.
This study compares complication rates between LZ and MB in SLNB patients, and the reliability dyes in locating sentinel lymph nodes.
Charts were reviewed for patients who underwent SLNB for skin cancers between September 2006 and November 2008 at Penn State Hershey Medical Center. The type and quantity of dye, the presence of blue stained sentinel nodes, and any complications were recorded.
Ninety-three patients underwent SLNB (46 LZ, 47 MB). The amount of dye used was similar (avg. 0.93 ml LZ, 1.24 ml MB). The complication rate of LZ was 8.7%, and MB was 25.5%. There was significantly more (P = 0.003) skin graft complications in the MB patients (6/12) versus LZ (0/15).
There is a higher rate of complications with MB, especially with skin grafting. The reported risk of anaphylaxis with LZ has not been reported in volumes <2 ml. The sentinel lymph node identification rate is historically similar between dyes, and in this study was noted to be higher with LZ. J. Surg. Oncol. 2011; 103:421–425. © 2010 Wiley-Liss, Inc.