Abstract
The application of iodine solution to the epithelium of the hypopharynx before cutting the surgical margin off was studied to determine its feasibility as an aid to resection.
From 1997 to 2006, 82 cases of hypopharynx carcinoma were treated at Fukushima Medical University Hospital, of which 43 cases underwent laryngo-pharyngectomy. These 43 cases were selected for the present study. In 32 of these cases, marginal sections were diagnosed pathologically during operation by frozen-section. In 23 of the 32 cases, iodine stained samples were examined, and the unstained area was restricted to the area of resection. In the other 11 cases, the margin of resection was determined by gross view.
One case developed marginal recurrence, whose margin of resection was determined by visual examination. There were no cases of marginal recurrence, whose margin of resection was determined in frozen-section pathologically.
In 32 cases, margins of resection were diagnosed by frozen-section, although further excision was added until the margin became negative. A significant difference in the incidence of positive margin at the first resection was observed between the cases with iodine staining (2 of 23 cases) and those without iodine staining (4 of 9 cases). In 23 cases with iodine staining, four cases were skipped to unstained areas and these pathological diagnoses were as follows; invasive carcinoma, carcinoma-in-situ, dysplasia, and granulation.
Iodine staining for laryngo-pharyngectomy showed hidden malignant lesions and aids accurate resection of hypopharyngeal carcinoma.
