LONG-TERM FOLLOW-UP OF COLLATERAL PATHWAYS ESTABLISHED AFTER LYMPHADENECTOMY IN RATS
Abstract
A collateral pathway established after
lymphadenectomy could play an important
role in long-term lymphedema treatment.
The present study investigated alterations
of lymph dynamics 1 year after lymphadenectomy
using indocyanine green fluorescent
lymphography to determine if a collateral
pathway may be used for long-term
lymphedema treatment. Wistar rats were
anaesthetized and lymph nodes were excised
at the inguinal and popliteal fossae. The
treated hind limb was evaluated by fluorescent
lymphography between 10 weeks and 6
months and between 6 months and 1 year
postoperatively. Fluorescent lymphography
demonstrated a lymphatic pathway to the
ipsilateral axillary fossa in all rats 1 year after
lymphadenectomy. Some capillary branches
in the paths leading to the ipsilateral axillary
fossa were dilated and tortuous. In addition,
areas in which a fluorescent signal was not
visible were increased in the thigh. In conclusion,
the collateral pathway did not appear to
be only for temporary use to compensate for
drainage from the edematous limb but appears
more stable as a component of a compensating
lymphatic system. These new dilated vessels,
although functional at this point, may still be
susceptible to disturbance by further alteration
to the lymph vessels.