Effect of Variable Injection Sites for Indocyanine Green Dye on the Success of Lymphaticovenular Anastomosis

Takashi Nuri, H. Iwanaga, Yuki Otsuki, K. Ueda
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引用次数: 2

Abstract

Abstract Background Indocyanine green lymphography (ICGL) allows more accurate visualization for lymphaticovenular anastomosis (LVA). However, the protocol for ICGL has not been established yet. We investigated how injection sites of ICG affect lymphography results by comparing ICGL images based on different injection sites on the same patients. Methods Our hospital followed two ICGL protocols over time: ICG was injected into patients' 1st to 4th toe web spaces during 2013 to 2017 (Protocol 1), but into their lateral and medial ankles and 1st and 4th toe web spaces starting in 2018 (Protocol 2). Ten patients with secondary lymphedema who underwent LVA twice, using each protocol, were included in this study. We compared their results in detail and evaluated the effects of variable ICG injection sites. Results The average period between patients' first and second LVAs was 506 days. In six patients, Protocol 2 detected new and additional linear findings that had not been detected by Protocol 1. Average reduction of lower limb circumferences after second LVAs (using Protocol 2) was 2.73 cm in patients who showed new linear findings, whereas those with no new findings showed little reduction. Conclusion LVA based on ICG injections only into the dorsum of the foot can miss valuable findings. Variable ICG injection sites may improve detection of lymphatic flow and LVA efficacy.
吲哚菁绿不同注射部位对淋巴小静脉吻合术成功的影响
摘要背景 吲哚菁绿淋巴造影术(ICGL)可以更准确地显示淋巴结-淋巴管吻合(LVA)。然而,ICGL的协议尚未制定。我们通过比较同一患者不同注射部位的ICGL图像,研究了ICG注射部位如何影响淋巴造影结果。方法 随着时间的推移,我们医院遵循了两项ICGL方案:2013年至2017年,ICG被注射到患者的第1至第4趾网空间(方案1),但从2018年开始,注射到他们的外侧和内侧脚踝以及第1和第4趾网上空间(方案2)。本研究纳入了10名继发性淋巴水肿患者,他们使用每种方案接受了两次LVA。我们详细比较了他们的结果,并评估了可变ICG注射部位的效果。后果 患者第一次和第二次LVA之间的平均时间为506天。在6名患者中,方案2检测到了方案1未检测到的新的和额外的线性发现。第二次LVA(使用方案2)后下肢周长的平均减少为2.73 cm,而那些没有新发现的患者几乎没有减少。结论 基于仅在足背注射ICG的LVA可能会错过有价值的发现。可变的ICG注射部位可以提高淋巴流的检测和LVA的疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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14 weeks
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