title: Lymphatic dysfunction after ligation surgery for varicose vein.
abstract: OBJECTIVE
  Although the lymphatic complications such as lymphocele sometimes occur after surgery for varicose veins, the lymphatic function of such patients has not been evaluated. In this case report, we present a case of lymphocele after ligation surgery for varicose vein. We also detected subclinical dysfunction in lower limb using indocyanine green (ICG) lymphography.
  
  
  METHODS
  A 76 year- old female underwent ligation surgery for right lower leg varicose vein, and she noticed the squashy lesion in the medial side of the right knee. Three years later, she consulted our clinic and we performed ICG lymphography. We observed dermal backflow around the mass, which indicated lymphatic dysfunction. After injecting additional ICG around the knee, we punctured and drained the clear, yellow fluid from the mass and it was contrasted with ICG during the examination and the involvement of the lymphatic system was proven.
authors.affiliation: Department of Lymphatic and Reconstructive Surgery, Saiseikai Kawaguchi General Hospital, Saitama, Japan.
authors.forename: Hisako
authors.initials: H
authors.lastname: Hara
authors.affiliation: Department of Lymphatic and Reconstructive Surgery, Saiseikai Kawaguchi General Hospital, Saitama, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Mihara
authors.affiliation: Department of Rehabilitation, Saiseikai Kawaguchi General Hospital, Saitama, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Hasegawa
authors.affiliation: Department of Nursing, Saiseikai Kawaguchi General Hospital, Saitama, Japan.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Yamanaka
keywords: Indocyanine green; high ligation; lymphatic dysfunction; lymphedema; varicose vein