Early diagnosis of lymphedema and indication of preventive lymphatic venous anastomosis

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Lymphedema often develops as a postoperative complication of breast and uterine cancer. Lymphadenectomy and radiation therapy increase the rate of onset of lymphedema. However, it is difficult to detect lymphedema at an early stage, often resulting in developed lymphedema at the initial visit. To address this issue, Lymphangiography using ICG dye was performed on the patients who had gynecological operation requiring pelvic lymphadenectomy. The assessment was done before and after surgery. In the result, lymphedema was shown to develop in patients with poor preoperative lymphatic flow, which could be indication for preventive LVA. And we found the ICG image showing early lymphedema in subclinical state. Based on the results, it is possible to prevent to develop lymphedema and diagnose early lymphedema.