Multi-area lymphaticovenous anastomosis with multi-lymphosome injection in indocyanine green lymphography: A prospective study.
Adult
Aged
Anastomosis, Surgical
/ methods
Case-Control Studies
Female
Follow-Up Studies
Humans
Indocyanine Green
Injections, Intralesional
Lymphatic Vessels
/ surgery
Lymphedema
/ diagnostic imaging
Lymphography
/ methods
Lymphoscintigraphy
/ methods
Male
Microsurgery
/ methods
Middle Aged
Preoperative Care
/ methods
Prospective Studies
Treatment Outcome
Veins
/ surgery
Journal
Microsurgery
ISSN: 1098-2752
Titre abrégé: Microsurgery
Pays: United States
ID NLM: 8309230
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
05
11
2017
revised:
10
03
2018
accepted:
07
08
2018
pubmed:
7
12
2018
medline:
6
6
2019
entrez:
4
12
2018
Statut:
ppublish
Résumé
Detecting more number of functional lymphatic vessels is the essential point in lymphaticovenous anastomosis (LVA). The purpose of this prospective study was to elucidate the efficacy of multi-area injection in indocyanine green (ICG) lymphography in LVA. We injected ICG into the first web spaces of the feet or the second web space of the hands, subcutaneously. In multi-area injection group, we injected additional ICG in other areas. We determined the incision design of LVA on the line at about 5 cm distal to dermal backflow point. In control group, we determined the incision site based on the linear pattern in ICG lymphography and lymphoscintigraphic findings. We performed LVA, and evaluated the circumference change and the intraoperative condition of the collecting lymphatic vessels based on Normal, Ectasis, Contraction, and Sclerosis Type (NECST) classification. Sixty patients (115 limbs) in multi-injection group and 49 patients (81 limbs) in control group were included. We injected ICG into an average of 1.9 sites in multi-injection group. The average number of anastomoses per limb was 3.3 in both groups. The average circumference change was -1.83% in multi-injection group and -0.34% in control group (P = .021). The percentage of the Ectasis type lymphatic vessels was 59.0% in multi-injection group and 40.2% in control group (P = 3.30 × 10 By injecting ICG into multiple sites in the affected limbs, we could detect a greater number of functional lymphatic vessels (Ectasis type) during LVA. This could lead to a better surgical result.
Sections du résumé
BACKGROUND
BACKGROUND
Detecting more number of functional lymphatic vessels is the essential point in lymphaticovenous anastomosis (LVA). The purpose of this prospective study was to elucidate the efficacy of multi-area injection in indocyanine green (ICG) lymphography in LVA.
METHODS
METHODS
We injected ICG into the first web spaces of the feet or the second web space of the hands, subcutaneously. In multi-area injection group, we injected additional ICG in other areas. We determined the incision design of LVA on the line at about 5 cm distal to dermal backflow point. In control group, we determined the incision site based on the linear pattern in ICG lymphography and lymphoscintigraphic findings. We performed LVA, and evaluated the circumference change and the intraoperative condition of the collecting lymphatic vessels based on Normal, Ectasis, Contraction, and Sclerosis Type (NECST) classification.
RESULTS
RESULTS
Sixty patients (115 limbs) in multi-injection group and 49 patients (81 limbs) in control group were included. We injected ICG into an average of 1.9 sites in multi-injection group. The average number of anastomoses per limb was 3.3 in both groups. The average circumference change was -1.83% in multi-injection group and -0.34% in control group (P = .021). The percentage of the Ectasis type lymphatic vessels was 59.0% in multi-injection group and 40.2% in control group (P = 3.30 × 10
CONCLUSIONS
CONCLUSIONS
By injecting ICG into multiple sites in the affected limbs, we could detect a greater number of functional lymphatic vessels (Ectasis type) during LVA. This could lead to a better surgical result.
Substances chimiques
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
167-173Informations de copyright
© 2018 Wiley Periodicals, Inc.