NEW TECHNOLOGY FOR PREVENTION OF POSTMASTECTOMIC LYMPHEDEMA OF UPPER LIMB | Issues of reconstructive and plastic surgery. 2019. № 3 (70). DOI: 10.17223/1814147/70/01

NEW TECHNOLOGY FOR PREVENTION OF POSTMASTECTOMIC LYMPHEDEMA OF UPPER LIMB

Modern technologies for surgical treatment of breast cancer (BC) are based on the principles of radical mastectomy by J.L. Madden (1965, 1972). This operation gives good long-term results (five-year survival rate reaches95.6%), but is not infrequently co-accompanied by the development of postmastectomy upper limb lymphedema. The incidence of this complication is 35 to 70%. In the last decade, the idea of preventing upper limb postmastectomy lymphoma has become popular, based on the technology of fluorescence imaging of lymph nodes draining the mammary gland. We (in an animal experiment) developed a technology for mapping inguinal lymph nodes basedon two lymphotropic fluorescents glowing under the influence of a red laser range with a wavelength of 670 nm(methylene blue) and infrared laser radiation (green radiation). embedded in the layout of the hardware and software complex of extended photodynamic imaging for differentiation of lymphatic flow pathways of closely spacedorgans. A two-contrast fluorescence method for differentiating lymphatic flow from a number of disposed organs forming a single pool of regional lymph nodes has become the basis for radical mastectomy with axillary lymphadenectomy and preservation of lymphatic drainage from the upper extremity. Lymph nodes that glow under theinfluence of the red laser range (wave length 670 nm) and the infrared laser range (wavelength 780 nm) are considered common to the mammary gland and upper extremity. Based on the technology we have developed, there will be a paradigm shift in breast surgery: first intraoperative mapping of axillary lymph nodes draining the mammarygland and upper extremity, then mastectomy with axillary lymph node dissection with preservation of drainage fromthe upper extremity. Our invention "A device for photodynamic imaging for differentiation of lymphatic drainagepathways" according to the results of the formal examination of applications for invention 15.01.2019 receiveda positive conclusion of the Federal Institute of Industrial Property (application No. 2018146689/14 (077991)).

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Keywords

рак молочной железы, лимфедема верхней конечности, картирование подмышечных лимфоузлов, индоцианин зеленый, метиленовый синий, breast cancer, upper extremity lymphedema, axillary lymph node mapping, indocyanine green, methylene blue

Authors

Name	Organization	E-mail
Baytinger V.F.	Institute of Microsurgery; Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky	baitinger@mail.tomsknet.ru
Kurochkina O.S.	Institute of Microsurgery	kurochkinaos@yandex.ru
Zvonarev Ye.G.	Toksovo Interdistrict Hospital	geka81_@mail.ru
Loyt A.A.	Saint Petersburg State University
Bureyev A.Sh.	Diagnostica Ltd; Tomsk State University	artem_bureev@mail.ru
Shum A.L.	Soft-Crisstal Ltd
Shirshin V.A.	Soft-Crisstal Ltd	victor.shirshin69@gmail.com
Dikman Ye.Yu.	Diagnostica Ltd; Tomsk Polytechnic University	eka.dikman@gmail.com

Всего: 8

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