Marvel et al: The effect of one-lung ventilation on sentinel lymph node mapping in dog lungs
Veterinary Surgery 7, 2026
🔍 Key Findings
- Study design: Prospective randomized experimental study involving 21 healthy Beagles assigned to one-lung ventilation (OLV; n = 12) or normal ventilation (NV; n = 9). Each dog received 2.5 mg ICG into a caudal lung lobe during thoracoscopy, followed by near-infrared fluorescence (NIRF) assessment at 10-minute intervals.
- High fluorescence detection rate: At least one fluorescent lymph node was detected in 19/21 dogs (90.5%), demonstrating the feasibility of thoracoscopic ICG-guided lymphatic mapping.
- Tracheobronchial lymph nodes were most common: A single sentinel lymph node (SLN) was identified in 13/19 dogs (68%); the right or left tracheobronchial lymph node was the SLN in 10/13 dogs (77%).
- Lymphatic drainage was variable: Six of 19 dogs (32%) had multiple simultaneously fluorescent draining lymph nodes. In 4/19 dogs (21%), the first fluorescent nodes did not include the right or left tracheobronchial lymph node, emphasizing the risk of inaccurate staging with routine anatomic sampling alone.
- OLV significantly delayed lymph node fluorescence: Median detection time was 30 minutes with OLV versus 10 minutes with NV (p = .0012), suggesting impaired lymphatic tracer transport during ipsilateral lung collapse.
- OLV reduced early mapping success numerically: Fluorescence was detected in 8/12 OLV dogs while the endobronchial blocker remained in place versus 9/9 NV dogs. Two additional OLV dogs demonstrated fluorescence after blocker removal; the between-group detection difference was not statistically significant (p = .104).
- Injection laterality did not significantly influence detection: Right versus left caudal lung injection did not significantly affect fluorescence location or detection time (p = .587 for time).
- Clinical implications: Routine tracheobronchial lymph node biopsy may miss the true SLN. Delaying OLV until after ICG injection may improve mapping, although this strategy requires prospective validation in dogs with pulmonary tumors; the present study involved healthy dogs.
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Multiple Choice Questions on this study
In Marvel 2026 et al., on pulmonary lymphatic mapping, which technique was used to identify fluorescent draining lymph nodes following caudal lung lobe injection?
In Marvel 2026 et al., on pulmonary lymphatic mapping, how were multiple lymph nodes classified when they were first observed to fluoresce simultaneously during scheduled thoracoscopic assessment?
In Marvel 2026 et al., on pulmonary lymphatic mapping, which intraoperative ventilation strategy was suggested to potentially improve sentinel lymph node identification during thoracoscopic surgery for a caudal lung tumor?
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