Quantity of lymph nodes correlates with improvement in lymphatic drainage in treatment of hind limb lymphedema with lymph node flap transfer in rats

Dung H. Nguyen, Pan Yu Chou, Yu Hsuan Hsieh, Arash Momeni, Yu Hua Dean Fang, Ketan M. Patel, Chin Yu Yang, Ming Huei Cheng

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Purpose This study was conducted to investigate the correlation between the number of vascularized lymph nodes (LN) transferred and resolution of hind limb lymphedema in a rat model. Methods Unilateral hind limb lymphedema was created in 18 male Sprague-Dawley rats following inguinal and popliteal LN resection and radiation. A para-aortic LN flap based on the celiac artery was subsequently transferred to the affected groin. The three study groups consisted of Group A (no LN transfer), Group B (transfer of a single vascularized LN), and Group C (transfer of three vascularized LNs). Volumetric analysis of bilateral hind limbs was performed using micro-CT imaging at 1, 2, and 3 months postoperatively. Lymphatic drainage was assessed with Tc99 lymphoscintigraphy preoperatively and at 3 months postoperatively. Results A statistically significant volume reduction was seen in Groups B and C compared to Group A at all time points. Volume reduction of Group A vs.Group B at 1 month (8.6% ± 2.0% vs. 2.7% ± 2.6%, P < 0.05), 2 months (9.3% ± 2.2% vs. -4.3% ± 2.7%, P < 0.05), and 3 months (7.6% ± 3.3% vs. -8.9% ± 5.2%, P < 0.05). Volume reduction of Group A vs. Group C at 1 month (8.6% ± 2.0% vs. -6.6% ± 3.1%, P < 0.05), 2 months (9.3% ± 2.2% vs. -10.2% ± 4.6%, P < 0.05), and 3 months (7.6% ± 3.3% vs. -9.1% ± 3.1%, P < 0.05). Of note, comparison of Groups B and C demonstrated greater volume reduction in Group C at 1 (P < 0.02) and 2 (P = 0.07) months postoperatively. Conclusions LN flap transfer is an effective procedure for the treatment of lymphedema. The number of vascularized LNs transferred correlates positively with the degree of volume reduction.

Original languageEnglish
Pages (from-to)239-245
Number of pages7
JournalMicrosurgery
Volume36
Issue number3
DOIs
Publication statusPublished - 2016 Mar 1

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Lymphedema
Drainage
Extremities
Lymph Nodes
Groin
Therapeutics
Celiac Artery
Lymphoscintigraphy
Sprague Dawley Rats
Radiation

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Nguyen, Dung H. ; Chou, Pan Yu ; Hsieh, Yu Hsuan ; Momeni, Arash ; Fang, Yu Hua Dean ; Patel, Ketan M. ; Yang, Chin Yu ; Cheng, Ming Huei. / Quantity of lymph nodes correlates with improvement in lymphatic drainage in treatment of hind limb lymphedema with lymph node flap transfer in rats. In: Microsurgery. 2016 ; Vol. 36, No. 3. pp. 239-245.
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title = "Quantity of lymph nodes correlates with improvement in lymphatic drainage in treatment of hind limb lymphedema with lymph node flap transfer in rats",
abstract = "Purpose This study was conducted to investigate the correlation between the number of vascularized lymph nodes (LN) transferred and resolution of hind limb lymphedema in a rat model. Methods Unilateral hind limb lymphedema was created in 18 male Sprague-Dawley rats following inguinal and popliteal LN resection and radiation. A para-aortic LN flap based on the celiac artery was subsequently transferred to the affected groin. The three study groups consisted of Group A (no LN transfer), Group B (transfer of a single vascularized LN), and Group C (transfer of three vascularized LNs). Volumetric analysis of bilateral hind limbs was performed using micro-CT imaging at 1, 2, and 3 months postoperatively. Lymphatic drainage was assessed with Tc99 lymphoscintigraphy preoperatively and at 3 months postoperatively. Results A statistically significant volume reduction was seen in Groups B and C compared to Group A at all time points. Volume reduction of Group A vs.Group B at 1 month (8.6{\%} ± 2.0{\%} vs. 2.7{\%} ± 2.6{\%}, P < 0.05), 2 months (9.3{\%} ± 2.2{\%} vs. -4.3{\%} ± 2.7{\%}, P < 0.05), and 3 months (7.6{\%} ± 3.3{\%} vs. -8.9{\%} ± 5.2{\%}, P < 0.05). Volume reduction of Group A vs. Group C at 1 month (8.6{\%} ± 2.0{\%} vs. -6.6{\%} ± 3.1{\%}, P < 0.05), 2 months (9.3{\%} ± 2.2{\%} vs. -10.2{\%} ± 4.6{\%}, P < 0.05), and 3 months (7.6{\%} ± 3.3{\%} vs. -9.1{\%} ± 3.1{\%}, P < 0.05). Of note, comparison of Groups B and C demonstrated greater volume reduction in Group C at 1 (P < 0.02) and 2 (P = 0.07) months postoperatively. Conclusions LN flap transfer is an effective procedure for the treatment of lymphedema. The number of vascularized LNs transferred correlates positively with the degree of volume reduction.",
author = "Nguyen, {Dung H.} and Chou, {Pan Yu} and Hsieh, {Yu Hsuan} and Arash Momeni and Fang, {Yu Hua Dean} and Patel, {Ketan M.} and Yang, {Chin Yu} and Cheng, {Ming Huei}",
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Quantity of lymph nodes correlates with improvement in lymphatic drainage in treatment of hind limb lymphedema with lymph node flap transfer in rats. / Nguyen, Dung H.; Chou, Pan Yu; Hsieh, Yu Hsuan; Momeni, Arash; Fang, Yu Hua Dean; Patel, Ketan M.; Yang, Chin Yu; Cheng, Ming Huei.

In: Microsurgery, Vol. 36, No. 3, 01.03.2016, p. 239-245.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Quantity of lymph nodes correlates with improvement in lymphatic drainage in treatment of hind limb lymphedema with lymph node flap transfer in rats

AU - Nguyen, Dung H.

AU - Chou, Pan Yu

AU - Hsieh, Yu Hsuan

AU - Momeni, Arash

AU - Fang, Yu Hua Dean

AU - Patel, Ketan M.

AU - Yang, Chin Yu

AU - Cheng, Ming Huei

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Purpose This study was conducted to investigate the correlation between the number of vascularized lymph nodes (LN) transferred and resolution of hind limb lymphedema in a rat model. Methods Unilateral hind limb lymphedema was created in 18 male Sprague-Dawley rats following inguinal and popliteal LN resection and radiation. A para-aortic LN flap based on the celiac artery was subsequently transferred to the affected groin. The three study groups consisted of Group A (no LN transfer), Group B (transfer of a single vascularized LN), and Group C (transfer of three vascularized LNs). Volumetric analysis of bilateral hind limbs was performed using micro-CT imaging at 1, 2, and 3 months postoperatively. Lymphatic drainage was assessed with Tc99 lymphoscintigraphy preoperatively and at 3 months postoperatively. Results A statistically significant volume reduction was seen in Groups B and C compared to Group A at all time points. Volume reduction of Group A vs.Group B at 1 month (8.6% ± 2.0% vs. 2.7% ± 2.6%, P < 0.05), 2 months (9.3% ± 2.2% vs. -4.3% ± 2.7%, P < 0.05), and 3 months (7.6% ± 3.3% vs. -8.9% ± 5.2%, P < 0.05). Volume reduction of Group A vs. Group C at 1 month (8.6% ± 2.0% vs. -6.6% ± 3.1%, P < 0.05), 2 months (9.3% ± 2.2% vs. -10.2% ± 4.6%, P < 0.05), and 3 months (7.6% ± 3.3% vs. -9.1% ± 3.1%, P < 0.05). Of note, comparison of Groups B and C demonstrated greater volume reduction in Group C at 1 (P < 0.02) and 2 (P = 0.07) months postoperatively. Conclusions LN flap transfer is an effective procedure for the treatment of lymphedema. The number of vascularized LNs transferred correlates positively with the degree of volume reduction.

AB - Purpose This study was conducted to investigate the correlation between the number of vascularized lymph nodes (LN) transferred and resolution of hind limb lymphedema in a rat model. Methods Unilateral hind limb lymphedema was created in 18 male Sprague-Dawley rats following inguinal and popliteal LN resection and radiation. A para-aortic LN flap based on the celiac artery was subsequently transferred to the affected groin. The three study groups consisted of Group A (no LN transfer), Group B (transfer of a single vascularized LN), and Group C (transfer of three vascularized LNs). Volumetric analysis of bilateral hind limbs was performed using micro-CT imaging at 1, 2, and 3 months postoperatively. Lymphatic drainage was assessed with Tc99 lymphoscintigraphy preoperatively and at 3 months postoperatively. Results A statistically significant volume reduction was seen in Groups B and C compared to Group A at all time points. Volume reduction of Group A vs.Group B at 1 month (8.6% ± 2.0% vs. 2.7% ± 2.6%, P < 0.05), 2 months (9.3% ± 2.2% vs. -4.3% ± 2.7%, P < 0.05), and 3 months (7.6% ± 3.3% vs. -8.9% ± 5.2%, P < 0.05). Volume reduction of Group A vs. Group C at 1 month (8.6% ± 2.0% vs. -6.6% ± 3.1%, P < 0.05), 2 months (9.3% ± 2.2% vs. -10.2% ± 4.6%, P < 0.05), and 3 months (7.6% ± 3.3% vs. -9.1% ± 3.1%, P < 0.05). Of note, comparison of Groups B and C demonstrated greater volume reduction in Group C at 1 (P < 0.02) and 2 (P = 0.07) months postoperatively. Conclusions LN flap transfer is an effective procedure for the treatment of lymphedema. The number of vascularized LNs transferred correlates positively with the degree of volume reduction.

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DO - 10.1002/micr.22388

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