PMID- 30508302
OWN - NLM
STAT- MEDLINE
DCOM- 20190605
LR  - 20190605
IS  - 1098-2752 (Electronic)
IS  - 0738-1085 (Linking)
VI  - 39
IP  - 2
DP  - 2019 Feb
TI  - Multi-area lymphaticovenous anastomosis with multi-lymphosome injection in 
      indocyanine green lymphography: A prospective study.
PG  - 167-173
LID - 10.1002/micr.30398 [doi]
AB  - BACKGROUND: Detecting more number of functional lymphatic vessels is the 
      essential point in lymphaticovenous anastomosis (LVA). The purpose of this 
      prospective study was to elucidate the efficacy of multi-area injection in 
      indocyanine green (ICG) lymphography in LVA. METHODS: We injected ICG into the 
      first web spaces of the feet or the second web space of the hands, 
      subcutaneously. In multi-area injection group, we injected additional ICG in 
      other areas. We determined the incision design of LVA on the line at about 5 cm 
      distal to dermal backflow point. In control group, we determined the incision 
      site based on the linear pattern in ICG lymphography and lymphoscintigraphic 
      findings. We performed LVA, and evaluated the circumference change and the 
      intraoperative condition of the collecting lymphatic vessels based on Normal, 
      Ectasis, Contraction, and Sclerosis Type (NECST) classification. RESULTS: Sixty 
      patients (115 limbs) in multi-injection group and 49 patients (81 limbs) in 
      control group were included. We injected ICG into an average of 1.9 sites in 
      multi-injection group. The average number of anastomoses per limb was 3.3 in both 
      groups. The average circumference change was -1.83% in multi-injection group and 
      -0.34% in control group (P = .021). The percentage of the Ectasis type lymphatic 
      vessels was 59.0% in multi-injection group and 40.2% in control group 
      (P = 3.30 x 10(-5) ). CONCLUSIONS: By injecting ICG into multiple sites in the 
      affected limbs, we could detect a greater number of functional lymphatic vessels 
      (Ectasis type) during LVA. This could lead to a better surgical result.
CI  - (c) 2018 Wiley Periodicals, Inc.
FAU - Hara, Hisako
AU  - Hara H
AD  - Department of Lymphatic and Reconstructive Surgery, Saiseikai Kawaguchi General 
      Hospital, Saitama, Japan.
FAU - Mihara, Makoto
AU  - Mihara M
AD  - Department of Lymphatic and Reconstructive Surgery, Saiseikai Kawaguchi General 
      Hospital, Saitama, Japan.
LA  - eng
PT  - Journal Article
DEP - 20181203
PL  - United States
TA  - Microsurgery
JT  - Microsurgery
JID - 8309230
RN  - IX6J1063HV (Indocyanine Green)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anastomosis, Surgical/methods
MH  - Case-Control Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - *Indocyanine Green
MH  - Injections, Intralesional
MH  - Lymphatic Vessels/*surgery
MH  - Lymphedema/*diagnostic imaging/*surgery
MH  - Lymphography/*methods
MH  - Lymphoscintigraphy/methods
MH  - Male
MH  - Microsurgery/methods
MH  - Middle Aged
MH  - Preoperative Care/methods
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Veins/*surgery
EDAT- 2018/12/07 06:00
MHDA- 2019/06/06 06:00
CRDT- 2018/12/04 06:00
PHST- 2017/11/05 00:00 [received]
PHST- 2018/03/10 00:00 [revised]
PHST- 2018/08/07 00:00 [accepted]
PHST- 2018/12/07 06:00 [pubmed]
PHST- 2019/06/06 06:00 [medline]
PHST- 2018/12/04 06:00 [entrez]
AID - 10.1002/micr.30398 [doi]
PST - ppublish
SO  - Microsurgery. 2019 Feb;39(2):167-173. doi: 10.1002/micr.30398. Epub 2018 Dec 3.