Anatomic Study of the Integrity of the Breast Lymphatic Network With Indocyanine Green in Breast Implant Surgery Through the Axillary Approach.

Autor:	Claudic Y; From the Department of Plastic, Reconstructive and Aesthetic Surgery, Micro- and Hand Surgery, Brest University Hospital, University of Brest, Boulevard Tanguy Prigent, Brest, France., Perruisseau-Carrier A; From the Department of Plastic, Reconstructive and Aesthetic Surgery, Micro- and Hand Surgery, Brest University Hospital, University of Brest, Boulevard Tanguy Prigent, Brest, France., Ta P; From the Department of Plastic, Reconstructive and Aesthetic Surgery, Micro- and Hand Surgery, Brest University Hospital, University of Brest, Boulevard Tanguy Prigent, Brest, France., Seizeur R; Department of Anatomy, Medical School, University of Brest, Brest, France., Hu W; From the Department of Plastic, Reconstructive and Aesthetic Surgery, Micro- and Hand Surgery, Brest University Hospital, University of Brest, Boulevard Tanguy Prigent, Brest, France.
Jazyk:	angličtina
Zdroj:	Annals of plastic surgery [Ann Plast Surg] 2023 May 01; Vol. 90 (5S Suppl 2), pp. S112-S119. Date of Electronic Publication: 2023 Jan 31.
DOI:	10.1097/SAP.0000000000003391
Abstrakt:	Introduction: The performance of a prosthetic breast augmentation through the axilla always makes the surgeon fear the possibility of damage to the breast lymphatic network. Indocyanine green is a fluorescent marker allowing the analysis of the lymphatic system. This anatomical work aims at demonstrating, thanks to the use of indocyanine green, whether the realization of a prosthetic breast augmentation by axillary way leads to lesions of the breast lymphatic network and also seeks to show the feasibility of detecting the axillary sentinel node after axillary breast augmentation. Material and Method: This is an anatomical study. After injection of indocyanine green in the periareolar area, a prosthetic breast augmentation was performed through the axilla. At the end of the procedure, a change in the distribution of indocyanine green in the skin or its abnormal presence was sought: at the level of the skin incision, the prosthetic space, or in contact with the prosthesis itself. The presence of green in these situations was synonymous with a lesion of the lymphatic network. In the opposite case, we considered that the lymphatic system was respected. After sampling, an axillary lymph node we also looked for the presence of indocyanine green at its contact. Results: We performed 22 breast injections. The lymphatic network could be demonstrated in 15 of them. Among these 15 injections, 12 (80%) were in favor of a preservation of the lymphatic network, whereas 3 (20%) evoked a lesion of the lymphatic network. In all subjects (100%), an axillary lymph node was found with the presence of indocyanine green within it. Conclusion: Our study is in favor of a preservation of the lymphatic network during a prosthetic breast augmentation by axillary way. Furthermore, with the collection of an axillary lymph node containing the dye from each subject, this work demonstrates the feasibility of axillary sentinel node detection with indocyanine green after axillary breast augmentation. Further work on live subjects and on a larger number of subjects would be necessary to confirm these results. Competing Interests: Conflicts of interest and sources of funding: none declared. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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