Department of Nursing, Graduate School of Medicine, Nagoya University, Nagoya, Aichi Japan.
Lymphology. 2013 Mar;46(1):12-9.
Secondary lymphedema is one of the sequella of cancer treatment that in inadequately understood. The purpose of the present study is to investigate lymphedema formation and to explore the escape routes for excess interstitial fluid using lymphadenectomy in a rat model. In twelve Wistar rats, lymph nodes in the right inguinal and popliteal fossas were completely removed and lymph vessels carefully ligated. After operation, treated hind limbs were evaluated by indocyanine green lymphography and circumferential measurement. Both evaluations were performed from day 3 to ten weeks. Approximately 2 to 3 weeks after operation, a network-like pattern of the fluorescent signal appeared around the surgical site which then transitioned into a linear pattern in the lower abdomen. Videorecordings identified fluorescent flow moving from the lower abdomen to the ipsilateral axillary lymph node and in some rats, the network-like pattern was also observed to pass transversely over the suprapubic region to the contralateral inguinal lymph nodes. The network-like pattern on the lower abdomen and the linear pattern to the axillary fossa were seen continuously to the end of observation. Circumferential measurements of the treated hind limbs increased initially and then declined over time. This imaging system may be useful to detect early changes in lymphatic flow before swelling occurs and further study is needed.
继发性淋巴水肿是癌症治疗的后遗症之一，目前人们对其了解不足。本研究旨在通过对大鼠模型进行淋巴结切除术来探讨淋巴水肿的形成机制和探讨过多间质液的逃逸途径。在 12 只 Wistar 大鼠中，完全切除右腹股沟和腘窝淋巴结，并仔细结扎淋巴管。手术后，通过吲哚菁绿淋巴造影和周径测量评估治疗后的后肢。从第 3 天到第 10 周进行这两种评估。手术后大约 2 至 3 周，手术部位周围出现荧光信号的网络状模式，然后在下腹部转变为线性模式。录像识别到荧光流从下腹部向同侧腋窝淋巴结移动，在一些大鼠中，也观察到网络状模式横向穿过耻骨区域到对侧腹股沟淋巴结。下腹部的网络状模式和向腋窝的线性模式一直持续到观察结束。治疗后后肢的周径测量最初增加，然后随时间减少。这种成像系统可能有助于在肿胀发生之前检测到淋巴流的早期变化，需要进一步研究。
