Early diagnosis of lymphedema and indication of preventive lymphatic venous anastomosis

淋巴水肿通常是乳腺癌和子宫癌术后的并发症。淋巴结切除术和放射治疗增加了水肿的发病率。然而，在早期阶段很难发现水肿，通常在初次就诊时就出现水肿。为了解决这个问题，对需要盆腔淋巴结清扫术的妇科手术患者进行了使用ICG染料的淋巴管造影。在手术前后进行评估。结果显示，术前淋巴流量差的患者会发生水肿，这可能是预防性LVA的指征。我们发现ICG图像显示亚临床状态的早期水肿。根据这些结果，有可能预防水肿的发展和早期诊断水肿。

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.