Sentinel lymph node biopsy (SLB) is a rational method to avoid unnecessary neck dissection in patients with clinical N 0 oral cancer. At our department, dye-guided SLB has beencarried out since 2000. Since March 2002, we combined dye-guided and radioisotope (RI)-guided techniques.We describe the introduction and present status of this new technique.
When adopting this RI technique, we encountered difficulties in understanding and cooperation by related personnel, including the nurses of the operating room. The problems pointed out focused on exposure of operators, nurses, and anesthesiologists to radioactivity, custody and disposition of radioactive waste, and radioactive contamination of operative and anesthetic instruments. We estimated that the average radiation dose to which the operators were exposed was 3.8 μSv. Radiation exposureof the nurses and anesthetists was negligible. The average radioactivity of the operation wastes was 1.3μSv/hr, and that of the operation instruments was 0.3 μSv/hr. These results indicate no problematicradioactive contamination, and we believe that this procedure causes no radiological damage to clinicalcoworkers. At present, we carry out combined dye-guided and RI-guided SLB with the cooperation of relatedpersonnel, including the nurses of the operation room.