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Mesoappendix as potential donor site for vascularized lymph node transfer: anatomic study.

Daniel Ruter1, Wei Chen2, Ramon Garza3

  • 1The Ohio State University, Columbus, Ohio.

The Journal of Surgical Research
|August 14, 2018
PubMed
Summary

The mesoappendix rarely contains lymph nodes suitable for autologous lymph node transfer to treat lymphedema. Its vascular structures are inconsistently adequate for microsurgical anastomosis, making it an unreliable donor site.

Keywords:
Appendicular lymph nodeLymphedemaMesoappendixSurgical treatment of lymphedemaVLNTVascularized lymph node transfer

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Area of Science:

  • Microsurgery
  • Vascularized tissue transfer
  • Lymphedema treatment

Background:

  • Lymphedema management relies on time-intensive manual lymphatic drainage and compression therapy.
  • Autologous lymph node transfer offers a microsurgical alternative for lymphedema treatment by transferring vascularized lymph nodes.
  • Identifying ideal donor sites that minimize morbidity is crucial for lymph node transfer procedures.

Purpose of the Study:

  • To evaluate the mesoappendix as a potential donor site for autologous lymph node transfer.
  • To assess the presence and size of lymph nodes within the mesoappendix.
  • To measure the caliber and length of the mesoappendix's artery and vein for microsurgical suitability.

Main Methods:

  • Examination of 25 mesoappendix pathology specimens resected for benign conditions.
  • Gross pathologic assessment for the presence of lymph nodes.
  • Measurement of appendicular artery and vein caliber and length at the point of ligation.

Main Results:

  • Lymph nodes were identified in only 8% (2 of 25) of the mesoappendix specimens.
  • Mean arterial and vein calibers were 0.87 mm and 0.86 mm, respectively.
  • Mean arterial and vein lengths were 1.70 cm and 1.84 cm, respectively, with 46% of specimens having vessels >0.8 mm caliber.

Conclusions:

  • The mesoappendix is an inconsistent source of lymph nodes for autologous lymph node transfer.
  • While some vascular structures meet microsurgical criteria, the rarity of lymph nodes limits its utility.
  • The mesoappendix is not a reliable donor site for vascularized lymph node transfer in lymphedema treatment.