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Feasibility of the internal mammary lymph node flap as a vascularized lymph node transfer: A cadaveric dissection
Christopher J Pannucci1, Patrick A Gerety2, Amber R Wang3
1Division of Plastic Surgery, University of Utah, Salt Lake City, UT. christopher.pannucci@hsc.utah.edu.
Microsurgery
|March 11, 2015
Summary
This study explored using internal mammary lymph nodes for vascularized lymph node transfer. Surgeons can identify lymph nodes in 80% of flaps, with 60% containing 1-3 transferable nodes.
Area of Science:
- Anatomy
- Surgical Innovation
- Microsurgery
Background:
- Investigating the internal mammary lymph node flap as a potential donor site.
- Assessing the feasibility of vascularized lymph node transfer using this flap.
Purpose of the Study:
- To determine the anatomical suitability of the internal mammary lymph node flap for lymph node transfer.
- To evaluate the reliability of surgeon assessment of lymph node presence and quantity.
Main Methods:
- Cadaveric dissections of internal mammary vessels and adjacent lymph nodes in ten specimens.
- Surgeon inspection and palpation to identify lymph node counts.
- Pathological examination for correlation of lymph node counts using Kappa statistic.
Main Results:
- Moderate correlation (kappa 0.57) between surgeon and pathologist lymph node counts.
- Surgeon inspection/palpation accurately predicted node presence/absence in 80% of specimens.
- Sixty percent of flaps contained 1-3 lymph nodes (mean 2.0 when present).
Conclusions:
- Internal mammary lymph node flaps are a viable option for vascularized lymph node transfer.
- Surgeon assessment is reasonably accurate for predicting lymph node presence.
- One to three lymph nodes can be reliably transferred from this donor site.
