TY  - CHAP
M1  - Book, Section
TI  - Sentinel Lymph Node Dissection, Melanoma
A1  - Ellison, E. Christopher
A1  - Zollinger, Jr., Robert M.
A1  - Pawlik, Timothy M.
A1  - Vaccaro, Patrick S.
A1  - Bitans, Marita
A1  - Baker, Anthony S.
PY  - 2022
T2  - Zollinger’s Atlas of Surgical Operations, 11e
AB  - Sentinel  lymph  node  dissection  is  an  important  procedure  in  the  staging  of  patients  with  cutaneous  melanoma.  Sentinel  lymph  node  dissection  is  indicated  in  patients  with  clinically  node-negative  melanoma  of  intermediate  or  greater  thickness  (>1  mm).  It  is  considered  for  melanomas  between  0.8  and  1  mm  in  depth.  If  thinner,  the  melanoma  should  have  associated  high  risk  factors  such  as  ulceration  or  a  mitotic  count  per  square  millimeter  of  1  or  more.  Additional  risk  factors  to  be  considered  are  age,  site,  Clark’s  level  of  invasion,  and  gender.  Skin  melanomas  have  a  straightforward  lymphatic  flow  that  can  be  mapped.  Sentinel  lymph  node  dissection  should  be  considered  prior  to  a  wide  excision  of  the  primary  melanoma  site,  however.  This  is  especially  important  if  a  rotational  skin  flap  is  planned  for  closure  because  the  resulting  scar  will  alter  the  dermal  lymphatic  flow.  A  sentinel  lymph  node  dissection  that  uses  both  radionuclide  and  blue  dye  is  highly  accurate  in  finding  positive  lymph  nodes.  It  allows  a  focused  pathologic  examination  by  the  pathologist  with  both  routine  hematoxylin  and  eosin  and  immunohistochemical  staining  on  the  lymph  nodes  that  are  most  likely  to  contain  metastases.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1187823644
ER  -