title: Using indocyanine green fluorescent lymphography and lymphatic-venous anastomosis for cancer-related lymphedema.
abstract: Advances in cancer therapy have increased the importance of improvement of quality of life after cancer survival. Cancer-related lymphedema or secondary lymphedema that occurs after lymph node dissection in resection of tumors of abdominal visceral organs can impair quality of life. However, standard curative treatment for secondary lymphedema has not been established. This may be due to the lack of a method for early diagnosis of lymphedema, and because of selection of conservative treatment such as compression therapy to delay edema progression in many cases. To develop a curative approach, we have performed definite diagnosis of early-stage lymphedema using magnetic resonance imaging and an indocyanine green fluorescent lymphography, followed by surgical treatment with lymphatic-venous anastomosis using supermicrosurgery. Herein, we report the first case of secondary lymphedema in which we performed early diagnosis and surgery using these techniques and achieved an almost complete cure of lymphedema. We suggest that early diagnostic imaging and early microsurgery is the key of lymphedema treatment.
authors.affiliation: Department of Plastic Surgery and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan. mihara@keiseigeka.name
authors.forename: Makoto
authors.initials: M
authors.lastname: Mihara
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Murai
authors.forename: Yohei
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Hisako
authors.initials: H
authors.lastname: Hara
authors.forename: Takuya
authors.initials: T
authors.lastname: Iida
authors.forename: Mitsunaga
authors.initials: M
authors.lastname: Narushima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Todokoro
authors.forename: Gentaro
authors.initials: G
authors.lastname: Uchida
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D005260:Female; D005456:Fluorescent Dyes; D006801:Humans; D007208:Indocyanine Green; D008197:Lymph Node Excision / Q000009:adverse effects*; D008209:Lymphedema / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D008220:Lymphography / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008866:Microsurgery; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D014680:Veins / Q000601:surgery
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green