{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T01:14:05Z","timestamp":1783646045584,"version":"3.55.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":60,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the AE1\/AE3-ICG Fluorescence Imaging Sentinel Lymph Node Research Project","award":["Project No.: 2021005"],"award-info":[{"award-number":["Project No.: 2021005"]}]},{"name":"the AE1\/AE3-ICG Fluorescence Imaging Sentinel Lymph Node Research Project","award":["Project No.: 2021005"],"award-info":[{"award-number":["Project No.: 2021005"]}]},{"name":"the AE1\/AE3-ICG Fluorescence Imaging Sentinel Lymph Node Research Project","award":["Project No.: 2021005"],"award-info":[{"award-number":["Project No.: 2021005"]}]},{"name":"the AE1\/AE3-ICG Fluorescence Imaging Sentinel Lymph Node Research Project","award":["Project No.: 2021005"],"award-info":[{"award-number":["Project No.: 2021005"]}]},{"name":"the AE1\/AE3-ICG Fluorescence Imaging Sentinel Lymph Node Research Project","award":["Project No.: 2021005"],"award-info":[{"award-number":["Project No.: 2021005"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>At present, in endometrial cancer surgery, sentinel lymph node tracing via cervical tracer injection is mainly used to assess the metastatic status of pelvic lymph nodes, but it is difficult to evaluate the metastatic status of para-aortic lymph nodes. This study aimed to explore the feasibility of tracing pelvic and para-aortic sentinel lymph nodes drained through different pathways by injecting different tracers via the cervix and proper ovarian ligament respectively during endometrial cancer surgery.A total of 32 patients with endometrial cancer who underwent laparoscopic surgery at the Affiliated Cancer Hospital of Guangxi Medical University from January 2024 to January 2026 were enrolled as the research subjects. Methylene blue solution was injected via the cervix to visualize pelvic sentinel lymph nodes, while indocyanine green (ICG) was injected via the proper ovarian ligament to visualize para-aortic sentinel lymph nodes. The visualization status of sentinel lymph nodes was observed.All sentinel lymph nodes (SLNs) visualized by cervical injection of methylene blue were confined to the pelvic cavity: 92% of lymphatic drainage followed the upper paracervical pathway (UPP), with SLNs located in the obturator and external iliac regions; 8% followed the lower paracervical pathway (LPP), with SLNs in the common iliac region; no infundibulopelvic ligament pathway (IPP) was detected.ICG injection via the proper ovarian ligament visualized SLNs draining through the IPP. The time to initial SLN visualization ranged from 10\u00a0s to 137\u00a0s (median, 45\u00a0s; mean, 50.9\u00a0s). Left-sided SLNs were situated in the para-aortic region between the inferior mesenteric artery and left renal vein, with a visualization rate of 80.6% and an accuracy of 95.8%. Right-sided SLNs were located on the inferior vena cava surface 2\u20133\u00a0cm above the aortic bifurcation, with a visualization rate of 93.8% and 100% accuracy. There was no overlap between the visualization pathways of methylene blue and ICG. One case of postoperative lymphatic fistula occurred.\u00a0The \u201cdual-path\u201d strategy\u2014using different tracers injected via the cervix and proper ovarian ligament to visualize pelvic and para-aortic SLNs respectively\u2014is feasible in endometrial cancer surgery, enabling more comprehensive and accurate assessment of lymph node metastatic status.<\/jats:p>","DOI":"10.1038\/s41598-026-48295-8","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T16:16:35Z","timestamp":1778516195000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preliminary study on the intraoperative application of the \u201cdual-path\u201d strategy for sentinel lymph node tracing in endometrial cancer"],"prefix":"10.1038","volume":"16","author":[{"given":"Fangyi","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinpeng","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruyu","family":"Shao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desheng","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooman Soleymani","family":"Majd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousheng","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"issue":"12","key":"48295_CR1","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1136\/ijgc-2024-005769","volume":"34","author":"S Cosma","year":"2024","unstructured":"Cosma, S. et al. Link between isolated para-aortic lymph node metastasis and intrauterine cancer site in early stage endometrial cancer. Int. J. Gynecol. Cancer 34(12), 1881\u20131887. https:\/\/doi.org\/10.1136\/ijgc-2024-005769 (2024).","journal-title":"Int. J. Gynecol. Cancer"},{"issue":"1","key":"48295_CR2","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1007\/s13193-020-01227-y","volume":"12","author":"S Suchetha","year":"2021","unstructured":"Suchetha, S., Mathew, A. P., Rema, P. & Thomas, S. Pattern of lymph node metastasis in endometrial cancer: a single institution experience. Indian J. Surg. Oncol. 12(1), 73\u201377. https:\/\/doi.org\/10.1007\/s13193-020-01227-y (2021).","journal-title":"Indian J. Surg. Oncol."},{"issue":"3","key":"48295_CR3","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1016\/j.ajog.2024.08.028","volume":"232","author":"E Kivek\u00e4s","year":"2025","unstructured":"Kivek\u00e4s, E. et al. Robotic-assisted versus conventional laparoscopic surgery for endometrial cancer: long-term results of a randomized controlled trial. Am. J. Obstet. Gynecol. 232(3), 304. https:\/\/doi.org\/10.1016\/j.ajog.2024.08.028 (2025).","journal-title":"Am. J. Obstet. Gynecol."},{"issue":"2","key":"48295_CR4","doi-asserted-by":"publisher","first-page":"210","DOI":"10.6004\/jnccn.2022.7096","volume":"21","author":"A Jamieson","year":"2023","unstructured":"Jamieson, A. & McAlpine, J. N. Molecular profiling of endometrial cancer from TCGA to clinical practice. J. Natl. Compr. Canc. Netw. 21(2), 210\u2013216. https:\/\/doi.org\/10.6004\/jnccn.2022.7096 (2023).","journal-title":"J. Natl. Compr. Canc. Netw."},{"issue":"1","key":"48295_CR5","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1002\/ijgo.14307","volume":"160","author":"A Dick","year":"2023","unstructured":"Dick, A. et al. 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