Dynamics of lymphatic regeneration and flow patterns after lymph node dissection

KS Blum, ST Proulx, P Luciani, JC Leroux… - Breast cancer research …, 2013 - Springer
KS Blum, ST Proulx, P Luciani, JC Leroux, M Detmar
Breast cancer research and treatment, 2013Springer
Abstract Knowledge about the mechanisms of regeneration of the lymphatic vasculature
after surgical trauma is essential for the development of strategies for the prevention and
therapy of lymphedema. However, little is known about the alterations of lymphatic flow
directly after surgical trauma. We investigated lymphatic function in mice using near-infrared
imaging for a period of 4 weeks after surgeries that mimic sentinel lymph node biopsy
(SLNB) or axillary lymph node dissection (ALND), by removal of the popliteal lymph node …
Abstract
Knowledge about the mechanisms of regeneration of the lymphatic vasculature after surgical trauma is essential for the development of strategies for the prevention and therapy of lymphedema. However, little is known about the alterations of lymphatic flow directly after surgical trauma. We investigated lymphatic function in mice using near-infrared imaging for a period of 4 weeks after surgeries that mimic sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND), by removal of the popliteal lymph node (LN) alone or together with the popliteal fat pad, respectively. SLNB-like surgery did not cause changes in lymphatic drainage in the majority of cases. In contrast, lymphatic drainage impairment shown by collecting vessel rupture, dermal backflow and rerouting of lymph flow via collateral vessels were observed after ALND-like surgery. All collateral vessels drained to the inguinal LN. These results indicate that less invasive surgery prevents lymphatic decompensation. They also reveal the development and maturation of collateral lymphatic vessels after extensive surgical trauma, which reroute the flow of lymph towards a different LN. These findings might be helpful for the development of strategies to prevent and/or treat post-surgical lymphedema.
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