Intraoperative Detection of Efferent Lymphatic Vessels Emerging from Lymph Node during Lymphatic Microsurgery
Intraoperative Detection of Efferent Lymphatic Vessels Emerging from Lymph Node during Lymphatic Microsurgery
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DOI：
10.1055/s-0038-1677039
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发表时间：
2019-06-01
影响因子：
2.1
通讯作者：
Mitsukawa, Nobuyuki
中科院分区：
文献类型：
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作者：
Akita, Shinsuke;Yamaji, Yoshihisa;Mitsukawa, Nobuyuki
背景虽然传出淋巴管吻合(ELVA)在淋巴管显微外科手术中的应用已有报道，但区分传出淋巴管和传入淋巴管的最佳方法尚未建立。方法根据吲哚青绿淋巴造影结果，将46条肢体62个腹股沟淋巴结分为4组：正常组15例，真皮返流期15例，I期18例，II期14例。术前超声检测靶区LN及连接LN的传入淋巴管。术中从传入淋巴管缓慢注入0.05mL专利蓝染料；随后染色的淋巴管(S)被诊断为传出淋巴管(S)。结果0期组和I期组的传出淋巴管大小和直径均显著大于其他组(P<0.05)。
Background Although the usefulness of efferent lymphaticovenular anastomosis (ELVA) in lymphatic microsurgery has been reported, the optimal method to distinguish efferent from afferent lymphatics is not yet established. We propose a novel technique to detect efferent lymphatics appropriate for anastomosis.Methods In total, 62 groin lymph nodes (LNs) of 46 limbs were divided into four groups based on the findings of indocyanine green lymphography: n =15 in normal, 15 in dermal backflow stage 0, 18 in stage I, and 14 in stage II groups. The target LN and afferent lymphatic connecting it were preoperatively detected using ultrasonography. Intraoperatively, 0.05 mL patent blue dye was slowly manually injected from the afferent lymphatic; the lymphatic(s) subsequently stained was diagnosed as the efferent lymphatic(s) emerging from the node. The success rates of efferent lymphatic detection, sizes of LN, and diameter of efferent lymphatics were compared among the groups.Results Both LN size and diameter of efferent lymphatic were significantly larger in the stage 0 and I groups than the other groups ( p