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Normal lymphatic pathways only were mapped on the right non-operated side (30/30). Following the collection of skin samples, a second ICG mapping of the left operated side only showed regeneration of the interrupted lymphatic pathway in 43% of rats (Fig. 6). FSLP connecting the superficial to the deep lymphatic network by a perforating lymph vessel was only seen in 27% (Fig. 7) and both phenomena were present in 30% of animals (Fig. 8).
Note that the observation of a deep lymphatic network underneath the cutaneous trunci muscle proves the existence of a connexion between the superficial and the deep lymphatic networks which might be due to lymphatic regeneration (Fig. 6), a FLSP (perforating vessel) (Fig. 7) or both phenomena (Fig. 8).
Fig. 8 - Example of lymph flow restoration by regeneration and FSLP (perforating vessel) in an operated rat.
Close-up views of the left arm and shoulder. On the left image (a), the black arrow indicates the main lymphatic pathway, the white circle shows the surgical site with removed brachial nodes, and the white arrow depicts a perforating vessel. In the central image (b), the grey arrow indicates a regenerated lymphatic vessel following fascia stretch. On the right picture (c), the white circle shows the surgical site and the white triangle presents a deep lymphatic network under the cutaneous trunci muscle after arm stretch.
Part 2
Accumulation of EBD in the popliteal lymph node
The accumulated amount of EBD in the popliteal lymph nodes is significantly higher in the group which underwent vibration than in the control group which received no intervention (respectively, 0.56 ± 0.26 and 0.14 ± 0.17, p = 0.0005). No difference in the accumulation of EBD is observed when local massage is compared to no intervention (respectively, 0.22 ± 0.16 and 0.14 ± 0.17,
p = 0.3008). However, a significant EBD accumulation in the popliteal nodes is detected when vibrations are applied rather than when local massage is applied (respectively, 0.56 ± 0.26, and 0.22 ± 0.16, p = 0.0028).
Quantities (μl) of EBD in sacral lymph nodes following vibration are higher than in the control group (respectively, 0.26 ± 0.09 and 0.01 ± 0.01, p<0.0001), which are also statistically different from those in the massage group (respectively, 0.26 ± 0.09 and 0.07 ± 0.06, p<0.0001).
Unlike the EBD quantities found in the popliteal lymph nodes and compared to control conditions, local massage increased the EBD amount in the sacral nodes (respectively, 0.07 ± 0.06 and
0.01 ± 0.01, p = 0.0029). The results are presented in graph 5.
Graph 5 - Amount of EBD (μg) accumulation in the popliteal (left) and sacral (right) lymph nodes (mean and sd).
Fig. 6 - Example of regeneration of interrupted lymphatic vessels in an operated rat.
Close-up views of the left arm and shoulder. On the left (a), the black arrows indicate the main lymphatic pathway, the white cir- cle the surgical site where brachial nodes were removed, and the arrow illustrates a regenerated lymphatic vessel. On the right (b), the black arrow indicates the main lymphatic pathway, the white triangle shows the deep lymphatic network under the cutaneous trunci muscle following stretching of the arm, and the white ar- rows illustrate the regenerated lymphatic vessels.
Fig. 7 - Example of FSLP (perforating vessel) in the operated rat.
Zoomed views of the left arm and shoulder. On the left side (a), the black arrow indicates the main lymphatic pathway, the white cir- cle shows the surgical site with removed brachial nodes, the white arrow displays a perforating vessel, and the grey arrow presents a lymphatic dead-end. In the central picture (b), the white arrow shows a perforating vessel following superficial fascia stretch. On the right (c), the white triangle indicates the deep lymphatic network under the cutaneous trunci muscle following arm stretch and the grey arrow presents a lymphatic dead-end. Note that there is no evolving lymphatic regeneration process inside the surgical site.
THE EUROPEAN JOURNAL OF LYMPHOLOGY - Vol. XXIX - Nr. 75 - 2017
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