Application of Indocyanine Green Lymphography Combined with Methylene Blue Staining for Accurate Position in Lymphaticovenular Anastomosis of Lower Limbs
Objective To investigate the application of indocyanine green lymphography combined with methylene blue staining in lymphaticovenular anastomosis(LVA)of lower limbs,and analyze the advantages of the improved localization method.Methods Forty patients with lower limb lymphedema treated in the author's department from October 2020 to May 2022 were selected as the study objects,and were divided into control group and study group according to random number table method,with 20 cases in each group.The patients were treated with LVA using indocyanine green(ICG)lymphography combined with methylene blue staining and simple ICG lymphography as the positioning method,respectively.The number of lymphatic vessels anastomosed,the time of lymphatic vessel search,and the time of lymphatic vessel anastomosis were compared.Lower extremity lymphedema index(LELI)was used as the prognostic index,the symptom relief of lymphedema half a year after LVA was evaluated in both research group and control group.Results The number of anastomotic lymphatic vessels in the study group was higher than that in the control group(P＜0.05),and the searching time of lymphatic vessels was lower than that in the control group;There was no significant difference in lymphatic anastomosis time between the two groups(P＞0.05).The LEL index of the research group and the control group half a year after LVA were lower than that before operation(P＜0.05).Conclusion ICG Indocyanine combined with methylene blue staining has the advantages of real-time visualization and accurate localization,which can increase the number of anastomotic lymphatic vessels,shorten the time of searching lymphatic vessels during operation.It has a good prognosis and high clinical application value.
lymphedema of lower limbslymphaticovenular anastomosissupermicrosurgeryindocyanine greenmethylene blueposition
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