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Assaf A Zeltzer, Carola Brussaard, Merel Koning, Randy De Baerdemaeker, Benoit Hendrickx, Moustapha Hamdi, Johan de Mey
BACKGROUND AND OBJECTIVES: Lymphedema is caused by insufficient lymphatic drainage leading to abnormal accumulation of interstitial fluid within soft tissues. Lympho-venous anastomosis (LVA), as a surgical option for selected patients, is widely applied. Through preoperative localization of functional lymphatics with indocyanine green, real time visualization of functioning lymphatic vessels is possible. This examination is time consuming and operator dependant and is not suitable to differentiate the ratio of fat hypertrophy to liquid edema...
August 16, 2018: Journal of Surgical Oncology
Yohann Renard, Louis de Mestier, Clémence Balaj, Jean-Michel Arnoux, Marc Labrousse, Gabriela Hossu, Manuela Perez
Surgical laparoscopic procedures in the retroperitoneal and supramesocolic spaces are increasingly frequent. There is a high risk of iatrogenic intraoperative injury of the retroperitoneal lymphatic structures during these procedures. A precise understanding of the anatomy of the thoracic duct (TD) and the cisterna chyli (CC) is essential for safe surgical procedures in this area. However, routine imaging procedures rarely and often incorrectly visualize the CC. The objective of this study was to evaluate the feasibility of a retrograde injection of the TD to fill the CC with a contrast agent in 16 human cadavers...
August 12, 2018: Journal of Anatomy
Kumiko Matsumoto, Akira Shinaoka, Kiyoshi Yamada, Yoshihiro Kimata
BACKGROUND:  Indocyanine green (ICG) fluorescence lymphography (ICGLG) that can visualize the lymphatic vessel and its flow noninvasively and dynamically was developed in 2007. It is frequently used to observe the function and pathway of the lymphatic vessels. ICGLG is simple and easy to perform, and it is useful for understanding the condition of the lymphatic system in real time. However, its protocol is not standardized. In addition, the lymphatic flow is enhanced by an exercise load such as walking...
August 12, 2018: Journal of Reconstructive Microsurgery
Hiroo Suami, Asha Heydon-White, Helen Mackie, Louise Koelmeyer, John Boyages
No abstract text is available yet for this article.
August 12, 2018: Journal of Reconstructive Microsurgery
Takumi Yamamoto, Takuya Iida, Hidehiko Yoshimatsu, Yuma Fuse, Akitatsu Hayashi, Nana Yamamoto
BACKGROUND: Lymph system plays important roles in maintaining fluid balances, immune system, and lipid metabolism. After tissue replantation or transfer, some cases suffer from long-lasting edema or lymphedema due to interruption of main lymph flows, but its mechanism is yet to be clarified. METHODS: Medical charts of 38 patients who underwent ICG lymphography after tissue replantation or free flap transfer were reviewed to obtain data of clinical demographics, intraoperative findings, and postoperative ICG lymphography findings...
June 22, 2018: Plastic and Reconstructive Surgery
Chin-Yu Yang, Olivia A Ho, Ming-Huei Cheng, Hui-Yi Hsiao
BACKGROUND: Vascularized lymph node transfer is a promising surgical treatment for lymphedema. This study investigates the effect of ischemia on the lymphatic drainage efficiency of vascularized lymph node flaps and the critical ischemia time of lymph nodes. METHODS: Twenty-four lymph nodes containing groin flaps in twelve Sprague-Dawley rats were dissected. Clamping of the vascular pedicle was performed for 0, 1, 3, 5, 6, 7 hours, then each allowed to re-perfuse via the vascular pedicle for one hour...
June 12, 2018: Plastic and Reconstructive Surgery
Kumiko Matsumoto, Jun Kosaka, Hiroo Suami, Yoshihiro Kimata
Background: The morphologic and histologic behavior of lymphatic vessels in lymphedema has not been well analyzed using laboratory animals. The purpose of the present study was to elucidate the regeneration process of lymphatic vessels after acute lymphedema in a rat model. Methods: The acute lymphedema was induced by an amputation and a replantation surgery on a rat hind limb. Recovery of lymphatic flow was traced using fluorescent lymphography with dye injection...
May 2018: Plastic and Reconstructive Surgery. Global Open
Fang Shi, Yue Yang, Jian Chen, Yan Sha, Yilai Shu, Haitao Wu
Objective: To investigate the potential use of indirect computed tomography lymphography (CT-LG) with dendrimer-entrapped gold nanoparticles (Au DENPs) in the localization and enhanced imaging of cervical sentinel lymph node (SLN) on rabbit model. Methods: Twelve rabbits were randomly divided into two groups: the positive control group and the experimental group. In the control group, indirect CT-LG was performed with the injection of 0.5 ml activated carbon nanoparticles (ACNP) and Omnipaque mixture suspension in the right tongue submucosa...
2018: BioMed Research International
Anouk J M Cornelissen, Tom J M van Mulken, Caitlin Graupner, Shan S Qiu, Xavier H A Keuter, René R W J van der Hulst, Rutger M Schols
Background: Near-infrared fluorescence (NIRF) imaging technique, after administration of contrast agents with fluorescent characteristics in the near-infrared (700-900 nm) range, is considered to possess great potential for the future of plastic surgery, given its capacity for perioperative, real-time anatomical guidance and identification. This study aimed to provide a comprehensive literature review concerning current and potential future applications of NIRF imaging in plastic surgery, thereby guiding future research...
2018: European Journal of Plastic Surgery
Nina Natascha Harke, Michael Godes, Christian Wagner, Mustapha Addali, Bernhard Fangmeyer, Katarina Urbanova, Boris Hadaschik, Jorn H Witt
PURPOSE: To demonstrate the benefits of fluorescence-supported extended pelvic lymph node dissection (ePLND) compared to regular ePLND in robot-assisted radical prostatectomy. METHODS: 120 patients with intermediate- or high-risk prostate cancer were prospectively randomized (1:1): in the intervention group, indocyanine green (ICG) was injected transrectally into the prostate before docking of the robot. In both groups, ePLND was performed including additional dissection of fluorescent lymph nodes (LN) in the ICG group...
May 16, 2018: World Journal of Urology
Yukari Nakajima, Kimi Asano, Kanae Mukai, Tamae Urai, Mayumi Okuwa, Junko Sugama, Toshio Nakatani
Since lymphedema rarely develops in the mouse hindlimb, the underlying mechanisms remain unclear. We herein investigated the resolution of chronic hindlimb lymphedema in mice using a Near-Infrared Fluorescence (NIRF) imaging system. Nineteen 7-28-week-old BALB/c male and female mice were injected with two dyes for lymphography and dissection. Lymphadenectomy was performed on six male mice to completely obstruct lymph flow in the hindlimb. Edematous changes in both hindlimbs were compared until 60 days after surgery...
May 4, 2018: Scientific Reports
Tamaki Fujita, Hiroyuki Miura, Hiroko Seino, Shuichi Ono, Takashi Nishi, Akimasa Nishimura, Kenichi Hakamada, Masahiko Aoki
To evaluate the anatomical classification and location of breast sentinel lymph nodes, preoperative computed tomography-lymphography examinations were retrospectively reviewed for sentinel lymph nodes in 464 cases clinically diagnosed with node-negative breast cancer between July 2007 and June 2016. Anatomical classification was performed based on the numbers of lymphatic routes and sentinel lymph nodes, the flow direction of lymphatic routes, and the location of sentinel lymph nodes. Of the 464 cases reviewed, anatomical classification could be performed in 434 (93...
September 2018: Anatomical Science International
Roberto García-Figueiras, Sandra Baleato-González, Anwar R Padhani, Antonio Luna-Alcalá, Ana Marhuenda, Joan C Vilanova, Iria Osorio-Vázquez, Anxo Martínez-de-Alegría, Antonio Gómez-Caamaño
Imaging techniques are clinical decision-making tools in the evaluation of patients with colorectal cancer (CRC). The aim of this article is to discuss the potential of recent advances in imaging for diagnosis, prognosis, therapy planning, and assessment of response to treatment of CRC. Recent developments and new clinical applications of conventional imaging techniques such as virtual colonoscopy, dual-energy spectral computed tomography, elastography, advanced computing techniques (including volumetric rendering techniques and machine learning), magnetic resonance (MR) imaging-based magnetization transfer, and new liver imaging techniques, which may offer additional clinical information in patients with CRC, are summarized...
May 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Evelyn S Qin, Mindy J Bowen, Wei F Chen
BACKGROUND: Bioimpedance spectroscopy (BIS) is used by healthcare specialists to diagnose lymphedema. BIS measures limb fluid content by assessing tissue resistance to the flow of electric current. However, there is debate regarding the validity of BIS in diagnosing early lymphedema. Indocyanine green (ICG) lymphography has been established as the most accurate diagnostic modality to date for lymphedema diagnosis. In this retrospective study, we test the sensitivity, specificity, and diagnostic accuracy of BIS in diagnosing lymphedema by referencing its results with ICG lymphography...
July 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Ji-Hyun Kim, Hakyoung Yoon, Hun-Young Yoon, Kidong Eom, Hyun-Jeong Sung, Jung-Hyun Kim
A puppy was diagnosed with lymphangiosarcoma associated with lymphedema based on lymphography and histopathology. The lesions resolved after toceranib therapy, and the dog remains in remission 1 year later. This is the first report of a successful outcome following oral toceranib as first-line therapy for lymphangiosarcoma in a dog.
April 2018: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
Johnson Chia-Shen Yang, Shao-Chun Wu, Min-Hsien Chiang, Wei-Che Lin, Ching-Hua Hsieh
BACKGROUND: For current lymphatico-venous anastomosis (LVA), the identification of "functional" lymphatic collecting vessels (LCVs) is mainly based on indocyanine green (ICG) lymphography. However, some of the non-ICG enhanced LCVs utilized for LVA were found to have visual lymphatic flow. OBJECTIVES: Should non-ICG enhanced, but flow-positive LCVs be considered functional as well? METHODS: A retrospective study with 56 consecutive lymphedema patients (8 male/48 female) received LVA...
April 2018: Journal of Surgical Oncology
Yun-Whan Lee, Soo-Hyun Lee, Hi-Jin You, Jae-A Jung, Eul-Sik Yoon, Deok-Woo Kim
BACKGROUND: Intraoperative indocyanine green (ICG) lymphography can effectively detect functioning lymph vessels in edematous limbs. However, it is sometimes difficult to clearly identify their course in later-stage edematous limbs. For this reason, many surgeons rely on experience when they decide where to make the skin incision to locate the lymphatic vessels. The purpose of this study was to elucidate lymphatic vessel flow patterns in healthy upper extremities in a Korean population and to use these findings as a reference for lymphedema treatment...
March 2018: Archives of Plastic Surgery
Yue Yang, Benqing Zhou, Jian Zhou, Xiangyang Shi, Yan Sha, Haitao Wu
OBJECTIVE: To evaluate the capability of indirect computed tomography and magnetic resonance lymphography (CT/MR-LG) with gadolinium-loaded, polyethylenimine-entrapped gold nanoprobes (Gd-Au PENPs) for assessing lingual sentinel lymph node (SLN) metastasis in a tongue VX2 carcinoma model. MATERIALS AND METHODS: Seventeen rabbits were used to establish a metastatic cervical lymph node model by implanting VX2 carcinoma suspension into the ventral tongue muscle. CT and MR images were acquired one hour after Gd-Au PENPs injection into the tongue submucosa bilaterally, on 1w (n = 4), 2w (n = 6) and 3w (n = 7) tumour-bearing rabbits after carcinoma transplantation...
August 2018: Acta Oto-laryngologica
Ryo Shirotsuki, Hiroo Uchida, Yujiro Tanaka, Chiyoe Shirota, Kazuki Yokota, Naruhiko Murase, Akinari Hinoki, Kazuo Oshima, Kosuke Chiba, Wataru Sumida, Masahiro Hayakawa, Takahisa Tainaka
BACKGROUND: Postoperative chylothorax after surgery for esophageal atresia/tracheoesophageal fistula (TEF) is a rare but serious complication, especially in neonates. This study aimed to identify the thoracic duct and ligate chylous leakage sites, using thoracoscopic navigation of an indocyanine-green (ICG)-based near-infrared (NIR) fluorescence imaging system. METHODS: From November 2014 to April 2017, thoracoscopic intraoperative ICG-NIR imaging was performed in 10 newborns (11 surgeries) with first TEF operation or with persistent postoperative chylothorax after TEF operation...
June 2018: Journal of Pediatric Surgery
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