Hara Hisako, Mihara Makoto
Department of Lymphatic and Reconstructive Surgery, JR Tokyo General Hospital, Tokyo, Japan.
Department of Lymphatic Surgery, Lymphedema Clinic, Tokyo, Japan.
Arch Plast Surg. 2024 Sep 17;51(6):592-596. doi: 10.1055/a-2375-8153. eCollection 2024 Nov.
It is observed that the locations of the most functional lymphatic vessels in the lymphedematous limbs can differ significantly from those in healthy limbs. The aim of this study was to elucidate the lymphatic map of lymphedematous limbs. We retrospectively analyzed 59 patients (118 limbs) with lower limb lymphedema. Fifty-five were women and four were men. The mean age and duration of lymphedema was 62.4 and 7.7 years, respectively. For the lateral thigh lymphosome, we injected indocyanine green (ICG) at the lateral knee and measured the distance (Dt) between the anterior superior iliac spine (ASIS) and the point where the lymphatic vessels crossed the reference line (the line connecting the ASIS and the patellar center). For the lateral calf lymphosome, we injected ICG at the lateral ankle and measured the distance (Dc) between the inferior patellar border and the point where the lymphatic vessels crossed the reference line (the anterior border of the tibia). In the lateral thigh, the mean Dt was 30.4 ± 0.6 cm (range, 0-41 cm) and the distribution peaked at approximately 30 cm from the ASIS. In the calf, the mean Dc was 13.1 ± 0.9 cm (range, -11 to 32 cm). The distribution of lymphatic vessel locations was highly variable. We could establish the lymphatic map in the lymphedematous legs. The distribution of lymphatic vessels in the thigh and lower legs had one and two peaks, respectively.
据观察，淋巴水肿肢体中功能最活跃的淋巴管位置与健康肢体中的位置可能有显著差异。本研究的目的是阐明淋巴水肿肢体的淋巴管分布图。我们回顾性分析了59例下肢淋巴水肿患者（118条肢体）。其中55例为女性，4例为男性。淋巴水肿的平均年龄和病程分别为62.4岁和7.7年。对于大腿外侧淋巴组，我们在膝关节外侧注射吲哚菁绿（ICG），并测量髂前上棘（ASIS）与淋巴管穿过参考线（连接ASIS和髌骨中心的线）的点之间的距离（Dt）。对于小腿外侧淋巴组，我们在踝关节外侧注射ICG，并测量髌下边界与淋巴管穿过参考线（胫骨前缘）的点之间的距离（Dc）。在大腿外侧，平均Dt为30.4±0.6 cm（范围为0 - 41 cm），分布在距ASIS约30 cm处达到峰值。在小腿，平均Dc为13.1±0.9 cm（范围为 - 11至32 cm）。淋巴管位置的分布变化很大。我们能够建立淋巴水肿腿部的淋巴管分布图。大腿和小腿的淋巴管分布分别有一个和两个峰值。
