Indocyanine Green Lymphographic Evidence of Surgical Efficacy Following Microsurgical and Supermicrosurgical Lymphedema Reconstructions.
Identifieur interne : 000F68 ( Main/Exploration ); précédent : 000F67; suivant : 000F69Indocyanine Green Lymphographic Evidence of Surgical Efficacy Following Microsurgical and Supermicrosurgical Lymphedema Reconstructions.
Auteurs : Wei F. Chen [États-Unis] ; Haidong Zhao [République populaire de Chine] ; Takumi Yamamoto (chirurgien) [Japon] ; Hisako Hara [Japon] ; Johnson Ding [États-Unis]Source :
- Journal of reconstructive microsurgery [ 1098-8947 ] ; 2016.
Abstract
Background Microsurgical vascularized lymph node transfer (VLNT) and supermicrosurgical lymphaticovenular anastomosis (LVA) are increasingly performed to treat lymphedema. The surgical outcome is commonly assessed by volume-based measurement (VBM), a method that is not consistently reliable. We describe indocyanine green (ICG) lymphography as an alternative postoperative tracking modality after lymphatic reconstruction with VLNT and LVA. Methods VLNT and LVA were performed in patients with therapy-refractory lymphedema. Patients were evaluated qualitatively by clinical assessment, quantitatively with VBM, and lymphographically using ICG lymphography. The evaluation was performed preoperatively, and at 3, 6, and 12-month postoperatively. Results Overall, 21 patients underwent lymphatic reconstruction with either VLNT or LVA. All reported prompt and durable relief of symptoms during the study period. All experienced disease regression based on the Campisi criteria. Out of the 21 patients, 20 (95%) demonstrated lymphographic down staging of disease severity. Out of the 21 patients, 3 (14%) developed a paradoxical increase in limb volume based on VBM despite clinical improvement. Conclusions ICG lymphography correlated highly with patient self-assessment and clinical examination, and is an effective postoperative tracking modality after lymphatic reconstruction.
DOI: 10.1055/s-0036-1586254
PubMed: 27487485
Affiliations:
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Chen</name><affiliation wicri:level="2"><nlm:affiliation>Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Iowa</region></placeName><wicri:cityArea>Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City</wicri:cityArea></affiliation></author><author><name sortKey="Zhao, Haidong" sort="Zhao, Haidong" uniqKey="Zhao H" first="Haidong" last="Zhao">Haidong Zhao</name><affiliation wicri:level="1"><nlm:affiliation>Division of Breast Surgery, Department of Surgery, The Second Hospital of Dalian Medical University, Dalian, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Division of Breast Surgery, Department of Surgery, The Second Hospital of Dalian Medical University, Dalian</wicri:regionArea><wicri:noRegion>Dalian</wicri:noRegion></affiliation></author><author><name sortKey="Yamamoto, Takumi" sort="Yamamoto, Takumi" uniqKey="Yamamoto T" first="Takumi" last="Yamamoto">Takumi Yamamoto (chirurgien)</name><affiliation wicri:level="4"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-Ku, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-Ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName><placeName><settlement type="city">Tokyo</settlement><region type="province">Région de Kantō</region></placeName><orgName type="university" n="3">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Hara, Hisako" sort="Hara, Hisako" uniqKey="Hara H" first="Hisako" last="Hara">Hisako Hara</name><affiliation wicri:level="4"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-Ku, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-Ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Ding, Johnson" sort="Ding, Johnson" uniqKey="Ding J" first="Johnson" last="Ding">Johnson Ding</name><affiliation wicri:level="2"><nlm:affiliation>Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Iowa</region></placeName><wicri:cityArea>Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City</wicri:cityArea></affiliation></author></analytic><series><title level="j">Journal of reconstructive microsurgery</title><idno type="eISSN">1098-8947</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background Microsurgical vascularized lymph node transfer (VLNT) and supermicrosurgical lymphaticovenular anastomosis (LVA) are increasingly performed to treat lymphedema. The surgical outcome is commonly assessed by volume-based measurement (VBM), a method that is not consistently reliable. We describe indocyanine green (ICG) lymphography as an alternative postoperative tracking modality after lymphatic reconstruction with VLNT and LVA. Methods VLNT and LVA were performed in patients with therapy-refractory lymphedema. Patients were evaluated qualitatively by clinical assessment, quantitatively with VBM, and lymphographically using ICG lymphography. The evaluation was performed preoperatively, and at 3, 6, and 12-month postoperatively. Results Overall, 21 patients underwent lymphatic reconstruction with either VLNT or LVA. All reported prompt and durable relief of symptoms during the study period. All experienced disease regression based on the Campisi criteria. Out of the 21 patients, 20 (95%) demonstrated lymphographic down staging of disease severity. Out of the 21 patients, 3 (14%) developed a paradoxical increase in limb volume based on VBM despite clinical improvement. Conclusions ICG lymphography correlated highly with patient self-assessment and clinical examination, and is an effective postoperative tracking modality after lymphatic reconstruction.</div></front></TEI><affiliations><list><country><li>Japon</li><li>République populaire de Chine</li><li>États-Unis</li></country><region><li>Iowa</li><li>Région de Kantō</li></region><settlement><li>Tokyo</li></settlement><orgName><li>Université de Tokyo</li></orgName></list><tree><country name="États-Unis"><region name="Iowa"><name sortKey="Chen, Wei F" sort="Chen, Wei F" uniqKey="Chen W" first="Wei F" last="Chen">Wei F. Chen</name></region><name sortKey="Ding, Johnson" sort="Ding, Johnson" uniqKey="Ding J" first="Johnson" last="Ding">Johnson Ding</name></country><country name="République populaire de Chine"><noRegion><name sortKey="Zhao, Haidong" sort="Zhao, Haidong" uniqKey="Zhao H" first="Haidong" last="Zhao">Haidong Zhao</name></noRegion></country><country name="Japon"><region name="Région de Kantō"><name sortKey="Yamamoto, Takumi" sort="Yamamoto, Takumi" uniqKey="Yamamoto T" first="Takumi" last="Yamamoto">Takumi Yamamoto (chirurgien)</name></region><name sortKey="Hara, Hisako" sort="Hara, Hisako" uniqKey="Hara H" first="Hisako" last="Hara">Hisako Hara</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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