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Interaction between vascularized lymph node transfer and recipient lymphatics after lymph node dissection-a pilot

Hiroo Suami1, Mario F Scaglioni1, Katherine A Dixon2

  • 1Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.

The Journal of Surgical Research
|August 28, 2016
PubMed
Summary

Vascularized lymph node transfer (VLNT) may create new lymphatic pathways. This surgical technique helps severed lymphatic vessels connect to adjacent nodes, potentially relieving lymphedema.

Keywords:
CanineIndocyanine green fluorescence lymphographyLymph node dissectionLymphangiographyLymphatic systemLymphedemaVascularized lymph node transfer

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Area of Science:

  • Surgical innovation in lymphedema treatment.
  • Lymphatic system regeneration and repair.

Background:

  • Vascularized lymph node transfer (VLNT) is increasingly used for lymphedema.
  • The interaction between transferred lymph nodes and recipient lymphatics remains unclear.

Purpose of the Study:

  • To investigate anatomical lymphatic changes in canines post-lymph node dissection and irradiation.
  • To clarify the interaction between VLNT and recipient lymphatics in lymphedema relief.

Main Methods:

  • Two canines underwent unilateral axillary/neck node dissection and irradiation.
  • Vascularized lymph node transfer (VLNT) was performed after one year.
  • Lymphatic imaging (ICG, lymphangiography) and limb girth measurements were used.

Main Results:

  • Lymphatic dissection led to collateral pathway formation to contralateral cervical nodes.
  • Following VLNT, new collateral pathways connected to internal mammary nodes via the transferred node.
  • Only one canine developed lymphedema despite identical lymphatic changes.

Conclusions:

  • The lymphatic system exhibits a homing mechanism for severed vessels to connect with adjacent lymph nodes.
  • VLNT shows potential for creating new collateral pathways to alleviate lymphedema.