Kanter M A, Slavin S A, Kaplan W
Department of Surgery, Beth Israel Hospital, Boston, Mass.
Plast Reconstr Surg. 1990 Apr;85(4):573-80. doi: 10.1097/00006534-199004000-00012.
Although a multitude of operations exist for the treatment of lymphedema, none is highly successful. An experimental model that reliably and easily produces chronic lymphedema in an extremity would be useful to study treatments in a controlled and comparative manner and would enhance our understanding of the physiology and treatment of lymphedema. Many models that simulate clinical lymphedema have been described, but they suffer from cumbersome protocols, high laboratory costs, and an inconsistent yield of permanent lymphedema. We describe an experimental model for chronic lymphedema in the lower extremity of the rat that creates a lymphatic block in the groin induced by radiation treatment and one operation--surgical division of the superficial and deep lymphatics. All animals develop stable chronic lymphedema of the lower extremity within days of operation, with swelling that persists for at least 9 months. A mortality rate of 8 percent was associated with this technique. Methods for quantification of limb swelling are described, as is analysis of the lymphatic block by lymphoscintigraphic imaging of lymph channels and nodes. This model has the advantages of simplicity of technique, cost-effective use of rodent subjects, reproducibility of lymphedema, and quantification of results.
尽管存在多种治疗淋巴水肿的手术方法,但没有一种是非常成功的。一种能够可靠且容易地在肢体上产生慢性淋巴水肿的实验模型,对于以可控和比较的方式研究治疗方法将是有用的,并且会增进我们对淋巴水肿生理学和治疗方法的理解。已经描述了许多模拟临床淋巴水肿的模型,但它们存在操作流程繁琐、实验室成本高以及永久性淋巴水肿产生率不一致的问题。我们描述了一种大鼠下肢慢性淋巴水肿的实验模型,该模型通过放射治疗在腹股沟区造成淋巴阻塞,并通过一次手术——浅表和深部淋巴管的外科分离来实现。所有动物在术后数天内都会出现稳定的下肢慢性淋巴水肿,肿胀持续至少9个月。该技术的死亡率为8%。文中描述了肢体肿胀的量化方法,以及通过淋巴管和淋巴结的淋巴闪烁成像对淋巴阻塞进行分析的方法。该模型具有技术简单、啮齿动物受试者使用成本效益高、淋巴水肿可重复性以及结果可量化等优点。