Identificador persistente para citar o vincular este elemento: http://hdl.handle.net/10553/112164
Título: Visualization of accessory lymphatic pathways, before and after manual drainage, in secondary upper limb lymphedema using indocyanine green lymphography
Autores/as: Medina Rodríguez, María Elena 
de-La-Casa-Almeida, María
Martel Almeida, Efrén 
Ojeda-Cárdenes, Arminda
Medrano-Sánchez, Esther M.
Clasificación UNESCO: 32 Ciencias médicas
3205 Medicina interna
Palabras clave: Breast Cancer Lymphedema
Indocyanine Green
Lymphatic Vessels
Lymphography
Manual Lymphatic Drainage
Fecha de publicación: 2019
Publicación seriada: Journal of Clinical Medicine 
Resumen: Manual Lymphatic Drainage (MLD) appears to stimulate lymphatic contraction, aid in the development of secondary derivation pathways, and stimulate the appearance of collateral pathways that could function as the main drainage routes of the limb in case of lymphedema. Through stretching, call up maneuvers are used to stimulate lymphangion reflex contraction and, therefore, lymphatic function. The aim was to describe the presence of areas and pathways of collateral lymphatic drainage under basal conditions and to determine, using Indocyanine Green (ICG) lymphography, whether an increase in these pathways occurs after 30 min of manual lymphatic stimulation with only call up maneuvers according to the Leduc Method®®. In this prospective analytical study (pretest–posttest), the frequency of presentation of areas and collateral lymphatic pathways was analyzed in 19 patients with secondary lymphedema of the upper limb after breast cancer using an infrared camera. Analyses were completed at three time points: after ICG injection, at baseline (pretest), and after the application of MLD (post-test). The Leduc Method maneuvers were applied to the supraclavicular and axillary nodes, chest, back, Mascagni, and Caplan pathways. The areas visualized in the pretest continued to be visible in the posttest. Additional pathways and fluorescent areas were observed after the maneuvers. The McNemar test showed statistical significance (p = 0.008), the odds ratio was infinite, and the Cohen’s g value was equal to 0.5. Manual stimulation by call up maneuvers increased the observation frequency of areas and collateral lymphatic pathways. Therefore, ICG lymphography appears to be a useful tool for bringing out the routes of collateral bypass in secondary lymphoedema after cancer treatment.
URI: http://hdl.handle.net/10553/112164
ISSN: 2077-0383
DOI: 10.3390/jcm8111917
Fuente: Journal of Clinical Medicine[EISSN 2077-0383],v. 8 (11), (Noviembre 2019)
Colección:Artículos
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