[Lymphoscintigraphy for non-invasive long term follow-up of functional outcome in patients with autologous lymph vessel transplantation].

AIM

Autologous lymph vessel transplantation significantly improves the lymphdrainage in patients with primary and secondary lymphedema. The aim of the present study was to answer the question, whether scintigraphic long-term follow up and semiquantitative evaluation of lymphatic flow could prove the persisting success of this sophisticated microsurgical technique.

METHODS

In this study visual and semiquantitative lymphoscintigraphy was used to prove the function of lymphatic vessel grafts in 20 patients (17 females, 3 males) comparing a preoperative baseline study with postoperative follow up investigations for a period of 7 years. The reason for microsurgical lymph vessel transplantation was in 4 patients a primary and in 16 patients a secondary lymphedema. In 12 cases the transplantation site was at the upper extremity, in 8 cases at the lower limb.

RESULTS

In 17/20 patients lymphatic function significantly improved after autologous lymph vessel transplantation compared to the preoperative findings, as verified by visual improvement of lymph drainage and decrease of a numeric transportindex. In 5 cases the vessel graft could be directly visualized. In these patients with scintigraphic visualization of the vessel graft the transportindex decreases to a significantly greater extent compared to the preoperative baseline study. Only 3 patients did not benefit from microsurgical treatment

CONCLUSION

Lymphoscintigraphy combined with semiquantitative estimation of lymphatic transport kinetics has shown to be an easy, reliable and readily available technique to assess lymphatic function before and after autologous lymph vessel transplantation. Thus, the method is not only helpful in planning microsurgical treatment but also in monitoring the postoperative improvement of lymph drainage. Patients with scintigraphic visualization of the vessel graft showed a significant better postoperative outcome than those without. The scintigraphic visualization of the vessel graft therefore seems to indicate a favourable prognosis regarding to lymph drainage.