The effect of inguinal lymphatic manipulation on regional lymph flow patterns. 1993

J R Rubin, and L B Eberlin
Section of Vascular Surgery, Case Western Reserve University School of Medicine, Cleveland, OH 44106.

OBJECTIVE Because of the proximity of the inguinal lymphatics and the femoral vessels, lymph vessel manipulation during inguinal dissection is unavoidable, and this project was undertaken to evaluate the consequences. METHODS Thirty-five greyhound dogs underwent popliteal lymph node dissection, cannulation with microvascular silastic tubing, and infusion of 2.5% Patent blue violet (Sigma Chemical Co., St. Louis, Mo.) (visual enhancement) and technetium 99m-labeled human serum albumin (HSA). Animals underwent inguinal exploration with no manipulation (group 1; n = 9), local lymphatic ligation (group 2; n = 11), or radical excision and ligation (group 3; n = 15) of the inguinal lymph vessels. Lymphatic flow was calculated by 99mTc-HSA clearance (counts per minute) at the popliteal, inguinal, and iliac regions, before and after lymph vessel manipulation and was converted into percent change between the regions. RESULTS There was statistically reduced intralymphatic radioactivity in groups 2 and 3 compared with group 1 (p < 0.001; Student t test), whereas there was no significant difference between groups 2 and 3. CONCLUSIONS This demonstrates that lymphatic flow in this experimental model is significantly reduced when major channels are identified and ligated, although radical obliteration does not reduce flow more significantly than local ligation, implying that there is an alternate pathway for lymph flow.

UI MeSH Term Description Entries
D007264 Inguinal Canal The tunnel in the lower anterior ABDOMINAL WALL through which the SPERMATIC CORD, in the male; ROUND LIGAMENT, in the female; nerves; and vessels pass. Its internal end is at the deep inguinal ring and its external end is at the superficial inguinal ring. Inguinal Ring,Canal, Inguinal,Canals, Inguinal,Inguinal Canals,Inguinal Rings,Ring, Inguinal,Rings, Inguinal
D008026 Ligation Application of a ligature to tie a vessel or strangulate a part. Ligature,Ligations,Ligatures
D008196 Lymph The interstitial fluid that is in the LYMPHATIC SYSTEM. Lymphs
D008197 Lymph Node Excision Surgical excision of one or more lymph nodes. Its most common use is in cancer surgery. (From Dorland, 28th ed, p966) Lymph Node Dissection,Lymphadenectomy,Dissection, Lymph Node,Dissections, Lymph Node,Excision, Lymph Node,Excisions, Lymph Node,Lymph Node Dissections,Lymph Node Excisions,Lymphadenectomies,Node Dissection, Lymph,Node Dissections, Lymph
D008208 Lymphatic System A system of organs and tissues that process and transport immune cells and LYMPH. Lymphatic Systems
D008297 Male Males
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D004396 Coloring Agents Chemicals and substances that impart color including soluble dyes and insoluble pigments. They are used in INKS; PAINTS; and as INDICATORS AND REAGENTS. Coloring Agent,Dye,Dyes,Organic Pigment,Stain,Stains,Tissue Stain,Tissue Stains,Organic Pigments,Pigments, Inorganic,Agent, Coloring,Inorganic Pigments,Pigment, Organic,Pigments, Organic,Stain, Tissue,Stains, Tissue
D005260 Female Females
D006614 Hindlimb Either of two extremities of four-footed non-primate land animals. It usually consists of a FEMUR; TIBIA; and FIBULA; tarsals; METATARSALS; and TOES. (From Storer et al., General Zoology, 6th ed, p73) Hindlimbs

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