Developing a lower limb lymphedema animal model with combined lymphadenectomy and low-dose radiation

Chin Yu Yang, Dung H. Nguyen, Chih Wei Wu, Yu Hua Dean Fang, Ko Ting Chao, Ketan M. Patel, Ming Huei Cheng

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

This study was aimed to establish a consistent lower limb lymphedema animal model for further investigation of the mechanism and treatment of lymphedema. Methods: Lymphedema in the lower extremity was created by removing unilateral inguinal lymph nodes followed by 20, 30, and 40 Gy (groups IA, IB, and IC, respectively) radiation or by removing both inguinal lymph nodes and popliteal lymph nodes followed by 20 Gy (group II) radiation in Sprague-Dawley rats (350-400 g). Tc99 lymphoscintigraphy was used to monitor lymphatic flow patterns. Volume differentiation was assessed by microcomputed tomography and defined as the percentage change of the lesioned limb compared to the healthy limb. Results: At 4 weeks postoperatively, 0% in group IA (n = 3), 37.5% in group IB (n = 16), and 50% in group IC (n = 26) developed lymphedema in the lower limb with total mortality and morbidity rate of 0%, 56.3%, and 50%, respectively. As a result of the high morbidity and mortality rates, 20 Gy was selected, and the success rate for development of lymphedema in the lower limb in group II was 81.5% (n = 27). The mean volume differentiation of the lymphedematous limb compared to the health limb was 7.76% ± 1.94% in group II, which was statistically significant compared to group I (P < 0.01). Conclusions: Removal of both inguinal and popliteal lymph nodes followed by radiation of 20 Gy can successfully develop lymphedema in the lower limb with minimal morbidity in 4 months.

Original languageEnglish
Article numbere121
JournalPlastic and Reconstructive Surgery
Volume2
Issue number3
DOIs
Publication statusPublished - 2014 Mar 14

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Lymphedema
Lymph Node Excision
Lower Extremity
Animal Models
Radiation
Groin
Extremities
Lymph Nodes
Morbidity
Lymphoscintigraphy
Radiation Dosage
X-Ray Microtomography
Mortality
Sprague Dawley Rats
Health

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Yang, C. Y., Nguyen, D. H., Wu, C. W., Fang, Y. H. D., Chao, K. T., Patel, K. M., & Cheng, M. H. (2014). Developing a lower limb lymphedema animal model with combined lymphadenectomy and low-dose radiation. Plastic and Reconstructive Surgery, 2(3), [e121]. https://doi.org/10.1097/GOX.0000000000000064
Yang, Chin Yu ; Nguyen, Dung H. ; Wu, Chih Wei ; Fang, Yu Hua Dean ; Chao, Ko Ting ; Patel, Ketan M. ; Cheng, Ming Huei. / Developing a lower limb lymphedema animal model with combined lymphadenectomy and low-dose radiation. In: Plastic and Reconstructive Surgery. 2014 ; Vol. 2, No. 3.
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abstract = "This study was aimed to establish a consistent lower limb lymphedema animal model for further investigation of the mechanism and treatment of lymphedema. Methods: Lymphedema in the lower extremity was created by removing unilateral inguinal lymph nodes followed by 20, 30, and 40 Gy (groups IA, IB, and IC, respectively) radiation or by removing both inguinal lymph nodes and popliteal lymph nodes followed by 20 Gy (group II) radiation in Sprague-Dawley rats (350-400 g). Tc99 lymphoscintigraphy was used to monitor lymphatic flow patterns. Volume differentiation was assessed by microcomputed tomography and defined as the percentage change of the lesioned limb compared to the healthy limb. Results: At 4 weeks postoperatively, 0{\%} in group IA (n = 3), 37.5{\%} in group IB (n = 16), and 50{\%} in group IC (n = 26) developed lymphedema in the lower limb with total mortality and morbidity rate of 0{\%}, 56.3{\%}, and 50{\%}, respectively. As a result of the high morbidity and mortality rates, 20 Gy was selected, and the success rate for development of lymphedema in the lower limb in group II was 81.5{\%} (n = 27). The mean volume differentiation of the lymphedematous limb compared to the health limb was 7.76{\%} ± 1.94{\%} in group II, which was statistically significant compared to group I (P < 0.01). Conclusions: Removal of both inguinal and popliteal lymph nodes followed by radiation of 20 Gy can successfully develop lymphedema in the lower limb with minimal morbidity in 4 months.",
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Developing a lower limb lymphedema animal model with combined lymphadenectomy and low-dose radiation. / Yang, Chin Yu; Nguyen, Dung H.; Wu, Chih Wei; Fang, Yu Hua Dean; Chao, Ko Ting; Patel, Ketan M.; Cheng, Ming Huei.

In: Plastic and Reconstructive Surgery, Vol. 2, No. 3, e121, 14.03.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Developing a lower limb lymphedema animal model with combined lymphadenectomy and low-dose radiation

AU - Yang, Chin Yu

AU - Nguyen, Dung H.

AU - Wu, Chih Wei

AU - Fang, Yu Hua Dean

AU - Chao, Ko Ting

AU - Patel, Ketan M.

AU - Cheng, Ming Huei

PY - 2014/3/14

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N2 - This study was aimed to establish a consistent lower limb lymphedema animal model for further investigation of the mechanism and treatment of lymphedema. Methods: Lymphedema in the lower extremity was created by removing unilateral inguinal lymph nodes followed by 20, 30, and 40 Gy (groups IA, IB, and IC, respectively) radiation or by removing both inguinal lymph nodes and popliteal lymph nodes followed by 20 Gy (group II) radiation in Sprague-Dawley rats (350-400 g). Tc99 lymphoscintigraphy was used to monitor lymphatic flow patterns. Volume differentiation was assessed by microcomputed tomography and defined as the percentage change of the lesioned limb compared to the healthy limb. Results: At 4 weeks postoperatively, 0% in group IA (n = 3), 37.5% in group IB (n = 16), and 50% in group IC (n = 26) developed lymphedema in the lower limb with total mortality and morbidity rate of 0%, 56.3%, and 50%, respectively. As a result of the high morbidity and mortality rates, 20 Gy was selected, and the success rate for development of lymphedema in the lower limb in group II was 81.5% (n = 27). The mean volume differentiation of the lymphedematous limb compared to the health limb was 7.76% ± 1.94% in group II, which was statistically significant compared to group I (P < 0.01). Conclusions: Removal of both inguinal and popliteal lymph nodes followed by radiation of 20 Gy can successfully develop lymphedema in the lower limb with minimal morbidity in 4 months.

AB - This study was aimed to establish a consistent lower limb lymphedema animal model for further investigation of the mechanism and treatment of lymphedema. Methods: Lymphedema in the lower extremity was created by removing unilateral inguinal lymph nodes followed by 20, 30, and 40 Gy (groups IA, IB, and IC, respectively) radiation or by removing both inguinal lymph nodes and popliteal lymph nodes followed by 20 Gy (group II) radiation in Sprague-Dawley rats (350-400 g). Tc99 lymphoscintigraphy was used to monitor lymphatic flow patterns. Volume differentiation was assessed by microcomputed tomography and defined as the percentage change of the lesioned limb compared to the healthy limb. Results: At 4 weeks postoperatively, 0% in group IA (n = 3), 37.5% in group IB (n = 16), and 50% in group IC (n = 26) developed lymphedema in the lower limb with total mortality and morbidity rate of 0%, 56.3%, and 50%, respectively. As a result of the high morbidity and mortality rates, 20 Gy was selected, and the success rate for development of lymphedema in the lower limb in group II was 81.5% (n = 27). The mean volume differentiation of the lymphedematous limb compared to the health limb was 7.76% ± 1.94% in group II, which was statistically significant compared to group I (P < 0.01). Conclusions: Removal of both inguinal and popliteal lymph nodes followed by radiation of 20 Gy can successfully develop lymphedema in the lower limb with minimal morbidity in 4 months.

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