Contribution of the cadaveric recirculation system in the anatomical study of lymphatic drainage of the ovary: applications in the management of ovarian cancer.

IF 1.4 4区 医学 Q2 Medicine
Surgical and Radiologic Anatomy Pub Date : 2024-08-01 Epub Date: 2024-06-20 DOI:10.1007/s00276-024-03406-w
Floriane Murris, Ariane Weyl, Lobna Ouldamer, Jérôme Lorenzini, Julie Delvallee, Alejandra Martinez, Gwenael Ferron, Charlotte Chollet, Amaury De Barros, Elodie Chantalat
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Abstract

Purpose: The present knowledge about lymphatic drainage of the ovary is based on carcinological studies, but it has only rarely been studied under physiological conditions. However, it is one of the preferential routes of dissemination in ovarian cancer, and understanding it is therefore vital for optimal carcinological management.Our purpose was to evaluate the feasibility of an innovative technique to study the lymphatic drainage territories of the ovary using a recirculation module on the cadaveric model.

Methods: We injected patent blue into the cortex of twenty "revascularised" cadaver ovaries with the Simlife recirculation model. We observed the migration of the dye live and described the drainage territories of each ovary.

Results: We observed a staining of the lymphatic vessels and migration of the dye in all the subjects, systematically ipsilateral to the injected ovary. We identified a staining of the lumbo-aortic territory in 65% of cases, with a preferential lateral-caval involvement (60%) for the right ovary and lateral-aortic territory (40%) for the left ovary. A common iliac involvement was observed in only 10% of cases. In 57% of cases, the staining of the lumbo-aortic territory was associated with a staining of the suspensory ligament. The pelvic territory was involved in 50% of cases, with an external iliac staining in 25% of cases and internal in 20%.

Conclusion: Our study provides for a better understanding of lymphatic drainage of the ovary using a new detection method, and allows the possibility of improving the teaching for operators with a realistic model. Continuation of this work could lead to considering more targeted and thus less morbid lymph node sampling for lymph node staging in early-stage ovarian cancer.

Abstract Image

尸体循环系统在卵巢淋巴引流解剖学研究中的贡献:在卵巢癌治疗中的应用。
目的:目前对卵巢淋巴引流的了解主要基于癌症研究,但很少在生理条件下对其进行研究。我们的目的是评估在尸体模型上使用再循环模块研究卵巢淋巴引流区域的创新技术的可行性:方法:我们使用 Simlife 再循环模型向 20 个 "血管再通 "的尸体卵巢皮质注射了专利蓝。我们观察了染料的活体迁移,并描述了每个卵巢的引流区域:结果:我们观察到所有受试者的淋巴管染色和染料迁移,系统地观察注射卵巢同侧的淋巴管染色和染料迁移。我们在65%的病例中发现了腔主动脉区域的染色,右侧卵巢优先受累于侧腔(60%),左侧卵巢优先受累于侧主动脉区域(40%)。只有10%的病例累及髂总动脉。在 57% 的病例中,腹主动脉区域的染色与悬韧带的染色有关。50%的病例累及骨盆区域,25%的病例出现髂外染色,20%的病例出现髂内染色:我们的研究采用了一种新的检测方法,使人们对卵巢淋巴引流有了更好的了解,并有可能通过一个逼真的模型改进对操作者的教学。继续开展这项工作,可以考虑在早期卵巢癌的淋巴结分期中进行更有针对性的淋巴结取样,从而减少发病率。
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来源期刊
Surgical and Radiologic Anatomy
Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine
CiteScore
2.40
自引率
14.30%
发文量
0
期刊介绍: Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.
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