吲哚菁绿淋巴造影在超显微淋巴管静脉吻合中的应用

Experince of supermicrosurgical lymphaticovenular anastomosis with intraoperative indocyaninegreen lymphangiography

目的探讨吲哚菁绿淋巴管造影在超显微淋巴管静脉吻合中的应用价值。方法回顾性分析2015年4月至2017年5月在术中应用吲哚菁绿淋巴造影进行超显微淋巴管静脉吻合的患者共6例，3例预防性超显微淋巴管静脉吻合和3例治疗性超显微淋巴管静脉吻合。患者均为女性，年龄30—54岁，中位年龄46．5岁。结果术中共进行超显微淋巴管静脉吻合6次。术后随访7-32个月，中位随访时间23个月，3例预防性超显微淋巴管静脉吻合患者未出现上肢淋巴水肿，3例治疗性超显微淋巴管静脉吻合患者上肢淋巴水肿获得不同程度的改善。结论采用吲哚菁绿淋巴管造影，能帮助术者在术中实时发现和选择合适的淋巴管，并确认超显微淋巴管静脉吻合后的通畅性，保障手术效果。

Objective To figure out the clinical application value of indocyanine green （ICG） lymphangiography in supermicrosurgical lymphaticovenular anastomosis. Methods A total of 6 supermicrosurgical lymphaticovenular anastomosis with intraoperative ICG lymphangiography were performed during April 2015 to May 2017 and were analyzed retrospectively. All the cases are female （ range from 30 to 54 years old, median of 46.5 years old）, including 3 cases for prevention and 3 cases for treatment of lymphedema. Results A total 6 supermicrosurgical lymphaticovenular anastomosis were performed with intraoperative ICG lymphangiography to make sure the influx of lymph fluid to the vein. During the median of 23 months follow-up （range from 7 to 32 months）, the 3 preventive cases did not show upper limb lymphedema and the 3 theraputic cases were relieved at different levels. Conclusions Intraoperative ICG lymphangiography can provide real-time information to locate suitable lymph vessels and ascertain the anastomotic patency in supermicrosurgical lymphaticovenular anastomosis, thus improve the operation effectiveness.