Application of combined preoperative indocyanine green lymphography and ultrasonography for low-pressure vein localization in secondary lymphedema surgery for breast cancer

Asian J Surg. 2024 Jan;47(1):289-295. doi: 10.1016/j.asjsur.2023.08.121. Epub 2023 Aug 28.

Abstract

Background: This study aimed to investigate the value of preoperative indocyanine green (ICG) lymphography combined with ultrasonography for low-pressure vein localization in secondary lymphedema surgery for breast cancer.

Methods: A total of 29 patients who were admitted to the breast surgery department of our hospital from July 2019 to May 2021 were included in this study. All patients received preoperative reverse lymphography and ultrasonography for low-pressure vein in lymphedema surgery. Three arm circumferences were measured before surgery, 6 months after surgery, and 12 months after surgery for comparison with the healthy limb at the same time.

Results: Arm circumference at 12 months after surgery was significantly different from those at the preoperative period and 6 months after surgery (P < 0.05). However, this parameter after surgery was still significantly higher than that of the healthy limb (P < 0.05).

Conclusions: The application of preoperative ICG lymphography combined with ultrasonography for low-pressure vein localization before surgery can greatly shorten operation duration by reducing the number of ineffective incisions and improving the probability of vein-lymphatic vessel matching, while ensuring the postoperative efficacy for patients.

Keywords: Breast cancer; Lymphedema; Lymphography; Lymphovenous anastomosis; Ultrasonography.

MeSH terms

  • Anastomosis, Surgical
  • Breast Neoplasms* / complications
  • Breast Neoplasms* / diagnostic imaging
  • Breast Neoplasms* / surgery
  • Chronic Disease
  • Female
  • Humans
  • Indocyanine Green
  • Lymphedema* / diagnostic imaging
  • Lymphedema* / etiology
  • Lymphedema* / surgery
  • Lymphography
  • Ultrasonography

Substances

  • Indocyanine Green