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Unique Uses of SPY: An Approach to Groin Lymphatic Complications

Femoral artery reconstructive operations pose the risk of damage to the lymphatic system and leakage of lymph fluid into the groin. This leakage establishes a stagnant reservoir of protein-rich fluid, further placing the patient at risk for complications, especially a higher infection rate. The use...

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Autores principales: Lu, Karen B., Erickson, Cameron, Sanniec, Kyle, Amirlak, Bardia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635217/
https://www.ncbi.nlm.nih.gov/pubmed/31624662
http://dx.doi.org/10.1097/GOX.0000000000002164
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author Lu, Karen B.
Erickson, Cameron
Sanniec, Kyle
Amirlak, Bardia
author_facet Lu, Karen B.
Erickson, Cameron
Sanniec, Kyle
Amirlak, Bardia
author_sort Lu, Karen B.
collection PubMed
description Femoral artery reconstructive operations pose the risk of damage to the lymphatic system and leakage of lymph fluid into the groin. This leakage establishes a stagnant reservoir of protein-rich fluid, further placing the patient at risk for complications, especially a higher infection rate. The use of SPY technology (Stryker Corp/Novadaq Technologies, Kalamazoo, Mich) for lymphatic leaks have been described in previous studies. However, the management of persistent high-output lymphatic leaks addressed secondarily with SPY lymphangiography have yet to be reported. This case report describes a young male who underwent thrombectomy in the left common femoral artery, who presented several days later with a high-output chylous leak. The lymphatic leak was initially managed and failed conventional muscle flaps, and SPY lymphangiography was performed to manage the lymphatic leak during the secondary surgery. The lymphatic vessels were ligated and confirmed with SPY lymphangiography. The management of lymphatic groin complications aided by the use of SPY lymphangiography provided valuable data and allowed for better intraoperative visualization. Utilization of SPY technology allowed the surgeons to properly address all sites of leakage in an otherwise persistent lymphatic leak. Resolution of lymphatic leak was further confirmed with SPY. Lymphatic complications, particularly those in the groin area, are of significant concern to physicians. Any suspected chylous leak should be followed with SPY lymphangiography to ensure proper treatment and resolution. Prophylactic use of SPY technology in high-risk patients during lymphatic surgery of the groin may also be considered.
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spelling pubmed-66352172019-10-17 Unique Uses of SPY: An Approach to Groin Lymphatic Complications Lu, Karen B. Erickson, Cameron Sanniec, Kyle Amirlak, Bardia Plast Reconstr Surg Glob Open Case Report Femoral artery reconstructive operations pose the risk of damage to the lymphatic system and leakage of lymph fluid into the groin. This leakage establishes a stagnant reservoir of protein-rich fluid, further placing the patient at risk for complications, especially a higher infection rate. The use of SPY technology (Stryker Corp/Novadaq Technologies, Kalamazoo, Mich) for lymphatic leaks have been described in previous studies. However, the management of persistent high-output lymphatic leaks addressed secondarily with SPY lymphangiography have yet to be reported. This case report describes a young male who underwent thrombectomy in the left common femoral artery, who presented several days later with a high-output chylous leak. The lymphatic leak was initially managed and failed conventional muscle flaps, and SPY lymphangiography was performed to manage the lymphatic leak during the secondary surgery. The lymphatic vessels were ligated and confirmed with SPY lymphangiography. The management of lymphatic groin complications aided by the use of SPY lymphangiography provided valuable data and allowed for better intraoperative visualization. Utilization of SPY technology allowed the surgeons to properly address all sites of leakage in an otherwise persistent lymphatic leak. Resolution of lymphatic leak was further confirmed with SPY. Lymphatic complications, particularly those in the groin area, are of significant concern to physicians. Any suspected chylous leak should be followed with SPY lymphangiography to ensure proper treatment and resolution. Prophylactic use of SPY technology in high-risk patients during lymphatic surgery of the groin may also be considered. Wolters Kluwer Health 2019-06-19 /pmc/articles/PMC6635217/ /pubmed/31624662 http://dx.doi.org/10.1097/GOX.0000000000002164 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Case Report
Lu, Karen B.
Erickson, Cameron
Sanniec, Kyle
Amirlak, Bardia
Unique Uses of SPY: An Approach to Groin Lymphatic Complications
title Unique Uses of SPY: An Approach to Groin Lymphatic Complications
title_full Unique Uses of SPY: An Approach to Groin Lymphatic Complications
title_fullStr Unique Uses of SPY: An Approach to Groin Lymphatic Complications
title_full_unstemmed Unique Uses of SPY: An Approach to Groin Lymphatic Complications
title_short Unique Uses of SPY: An Approach to Groin Lymphatic Complications
title_sort unique uses of spy: an approach to groin lymphatic complications
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635217/
https://www.ncbi.nlm.nih.gov/pubmed/31624662
http://dx.doi.org/10.1097/GOX.0000000000002164
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