Retroperitoneal lymph nodal visualization using 30% Guajazulen blue (chromolymphography)

Guajazulen, a dark blue lipid-soluble dye was used to stain retroperitoneal lymph nodes before lymphadenectomy. Initially, a 30% solution of Guajazulen (Merck, Darmstadt, FRG) in iodinated oil (Lipiodol, Byk-Gulden, Konstant, FRG) was injected endolymphatically in the hindlimbs of pigs (n = 10) and dogs (n = 8) to better visualize retroperitoneal lymph nodes. Because of encouraging results, 11 patients with testicular cancer undergoing staging or therapeutic laparotomy underwent endolymphatic injection of this dye solution preoperatively. The excellent staining of retroperitoneal lymph nodes facilitated nodal selectivity during lymphadenectomy.