Predictive lymphatic mapping: a method for mapping lymphatic channels in patients with advanced unilateral lymphedema using indocyanine green lymphography.
Identifieur interne : 002668 ( Main/Exploration ); précédent : 002667; suivant : 002669Predictive lymphatic mapping: a method for mapping lymphatic channels in patients with advanced unilateral lymphedema using indocyanine green lymphography.
Auteurs : Makoto Mihara [Japon] ; Yukio Seki ; Hisako Hara ; Takuya Iida ; Aiko Oka ; Kazuki Kikuchi ; Mitsunaga Narushima ; Makiko Haragi ; Dominic Furniss ; Lawrence Hin-Lun ; Kito Mitsui ; Noriyuki Murai ; Isao KoshimaSource :
- Annals of plastic surgery [ 1536-3708 ] ; 2014.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Vaisseaux lymphatiques.
- diagnostic : Lymphoedème.
- Adulte, Adulte d'âge moyen, Agents colorants, Femelle, Humains, Lymphoedème, Sujet âgé, Vert indocyanine.
English descriptors
- KwdEn :
- MESH :
- chemical : Coloring Agents, Indocyanine Green.
- diagnosis : Lymphedema.
- pathology : Lymphatic Vessels.
- surgery : Lymphedema.
- Adult, Aged, Female, Humans, Middle Aged.
Abstract
In severe lymphedema, indocyanine green lymphography cannot be used to map lymphatic channels before lymphaticovenular anastomosis (LVA) because linear lymphatics cannot be detected in a severely affected leg. Here, we describe a new method, which we refer to as predictive lymphatic mapping, to predict the location of lymphatics for anastomosis in unilateral lymphedema, thereby improving surgical accuracy and efficiency. The approach consists of marking anatomical landmarks and joining selected landmarks with fixed lines. The distance from these fixed lines to lymphatic channels mapped by indocyanine green lymphography in the unaffected leg is then measured, scaled up based on the difference in circumference between the legs, and transposed to the affected leg. To date, we have used this method in 5 cases of unilateral or asymmetric lymphedema of the lower extremities. In no cases have we failed to find a lymphatic channel suitable for LVA within a 2-cm incision. These results suggest that predictive lymphatic mapping is a useful additional tool for surgeons performing LVA under local anesthesia, which will help to improve the accuracy of incisions and the efficiency of surgery.
DOI: 10.1097/SAP.0b013e31826a18b1
PubMed: 23486121
Affiliations:
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Le document en format XML
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<front><div type="abstract" xml:lang="en">In severe lymphedema, indocyanine green lymphography cannot be used to map lymphatic channels before lymphaticovenular anastomosis (LVA) because linear lymphatics cannot be detected in a severely affected leg. Here, we describe a new method, which we refer to as predictive lymphatic mapping, to predict the location of lymphatics for anastomosis in unilateral lymphedema, thereby improving surgical accuracy and efficiency. The approach consists of marking anatomical landmarks and joining selected landmarks with fixed lines. The distance from these fixed lines to lymphatic channels mapped by indocyanine green lymphography in the unaffected leg is then measured, scaled up based on the difference in circumference between the legs, and transposed to the affected leg. To date, we have used this method in 5 cases of unilateral or asymmetric lymphedema of the lower extremities. In no cases have we failed to find a lymphatic channel suitable for LVA within a 2-cm incision. These results suggest that predictive lymphatic mapping is a useful additional tool for surgeons performing LVA under local anesthesia, which will help to improve the accuracy of incisions and the efficiency of surgery.</div>
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<name sortKey="Haragi, Makiko" sort="Haragi, Makiko" uniqKey="Haragi M" first="Makiko" last="Haragi">Makiko Haragi</name>
<name sortKey="Hin Lun, Lawrence" sort="Hin Lun, Lawrence" uniqKey="Hin Lun L" first="Lawrence" last="Hin-Lun">Lawrence Hin-Lun</name>
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<name sortKey="Koshima, Isao" sort="Koshima, Isao" uniqKey="Koshima I" first="Isao" last="Koshima">Isao Koshima</name>
<name sortKey="Mitsui, Kito" sort="Mitsui, Kito" uniqKey="Mitsui K" first="Kito" last="Mitsui">Kito Mitsui</name>
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<country name="Japon"><region name="Région de Kantō"><name sortKey="Mihara, Makoto" sort="Mihara, Makoto" uniqKey="Mihara M" first="Makoto" last="Mihara">Makoto Mihara</name>
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