Liu Hin-Lun, Chung Joseph Chun-Kit
Division of Plastic and Reconstructive Surgery, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Department of Ear, Nose and Throat, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Lymphat Res Biol. 2019 Oct;17(5):537-542. doi: 10.1089/lrb.2018.0056. Epub 2019 Jan 29.
Vascularized lymph node transfer (VLNT) has become the established treatment for secondary lymphedema. The proposed mechanisms of VLNT include lymphangiogenesis and absorptive action of transplanted lymphatic tissue. Therefore, in theory, the lymph node content of lymph node flap is crucial to clinical response. The supraclavicular lymph node flap (SCLNF) has been described as one of the flap options for VLNT. However, its lymph node content has not been fully studied. The aim of this study is to find out the lymph node content of SCLNF with histological examination. Patients who required radical neck dissection or modified radical neck dissection due to cervical lymph node metastasis from head and neck cancer were included in this study. The SCLNF harvesting was performed as the first part of neck dissection. After flap harvesting, neck dissection was continued. The fresh SCLNF specimens were then sent for histological study. Twelve SCLNFs were studied. The mean age of patients was 67.5 (range, 54-84) years. There were 10 males and 2 females. Seven flaps were harvested from the left side of neck, while five flaps were harvested from the right side of neck. The mean width, height, and thickness of SCLNF were 5.9 ± 0.6, 4.0 ± 0.5, and 1.8 ± 0.2 cm, respectively. The mean number of lymph nodes per flap was 8 ± 4.7 (range, 3-15). The lymph node content of SCLNF was confirmed. Its lymph node content is comparable to other lymph node flaps used in VLNT.
带血管蒂淋巴结转移术(VLNT)已成为继发性淋巴水肿的既定治疗方法。VLNT的推测机制包括淋巴管生成和移植淋巴组织的吸收作用。因此,从理论上讲,淋巴结皮瓣中的淋巴结含量对临床反应至关重要。锁骨上淋巴结皮瓣(SCLNF)已被描述为VLNT的皮瓣选择之一。然而,其淋巴结含量尚未得到充分研究。本研究的目的是通过组织学检查确定SCLNF的淋巴结含量。本研究纳入了因头颈癌颈部淋巴结转移而需要进行根治性颈清扫术或改良根治性颈清扫术的患者。SCLNF采集作为颈清扫术的第一部分进行。皮瓣采集后,继续进行颈清扫术。然后将新鲜的SCLNF标本送去进行组织学研究。共研究了12个SCLNF。患者的平均年龄为67.5岁(范围54 - 84岁)。男性10例,女性2例。7个皮瓣取自颈部左侧,5个皮瓣取自颈部右侧。SCLNF的平均宽度、高度和厚度分别为5.9±0.6、4.0±0.5和1.8±0.2厘米。每个皮瓣的平均淋巴结数量为8±4.7个(范围3 - 15个)。SCLNF的淋巴结含量得到了证实。其淋巴结含量与VLNT中使用的其他淋巴结皮瓣相当。