Abstract：
OBJECTIVE: The present knowledge about lymphatic drainage of the ovary is based on carcinological studies, but it has only rarely been studied under physiological conditions. However, it is one of the preferential routes of dissemination in ovarian cancer, and understanding it is therefore vital for optimal carcinological management.Our purpose was to evaluate the feasibility of an innovative technique to study the lymphatic drainage territories of the ovary using a recirculation module on the cadaveric model.
METHODS: We injected patent blue into the cortex of twenty \"revascularised\" cadaver ovaries with the Simlife recirculation model. We observed the migration of the dye live and described the drainage territories of each ovary.
RESULTS: We observed a staining of the lymphatic vessels and migration of the dye in all the subjects, systematically ipsilateral to the injected ovary. We identified a staining of the lumbo-aortic territory in 65% of cases, with a preferential lateral-caval involvement (60%) for the right ovary and lateral-aortic territory (40%) for the left ovary. A common iliac involvement was observed in only 10% of cases. In 57% of cases, the staining of the lumbo-aortic territory was associated with a staining of the suspensory ligament. The pelvic territory was involved in 50% of cases, with an external iliac staining in 25% of cases and internal in 20%.
CONCLUSIONS: Our study provides for a better understanding of lymphatic drainage of the ovary using a new detection method, and allows the possibility of improving the teaching for operators with a realistic model. Continuation of this work could lead to considering more targeted and thus less morbid lymph node sampling for lymph node staging in early-stage ovarian cancer.
METHODS: We injected patent blue into the cortex of twenty \"revascularised\" cadaver ovaries with the Simlife recirculation model. We observed the migration of the dye live and described the drainage territories of each ovary.
RESULTS: We observed a staining of the lymphatic vessels and migration of the dye in all the subjects, systematically ipsilateral to the injected ovary. We identified a staining of the lumbo-aortic territory in 65% of cases, with a preferential lateral-caval involvement (60%) for the right ovary and lateral-aortic territory (40%) for the left ovary. A common iliac involvement was observed in only 10% of cases. In 57% of cases, the staining of the lumbo-aortic territory was associated with a staining of the suspensory ligament. The pelvic territory was involved in 50% of cases, with an external iliac staining in 25% of cases and internal in 20%.
CONCLUSIONS: Our study provides for a better understanding of lymphatic drainage of the ovary using a new detection method, and allows the possibility of improving the teaching for operators with a realistic model. Continuation of this work could lead to considering more targeted and thus less morbid lymph node sampling for lymph node staging in early-stage ovarian cancer.
摘要：
目的：目前关于卵巢淋巴引流的知识是基于癌症研究，但很少在生理条件下进行研究。然而,它是卵巢癌传播的优先途径之一，因此，了解它对于优化癌症管理至关重要。我们的目的是评估一种创新技术在尸体模型上使用再循环模块研究卵巢淋巴引流区域的可行性。
方法：我们使用Simlife再循环模型将专利蓝注射到20个“血运重建”尸体卵巢的皮质中。我们观察了染料的活体迁移，并描述了每个子房的排水区域。
结果：我们观察到所有受试者的淋巴管染色和染料的迁移，系统同侧注射的卵巢。我们在65％的病例中确定了腰主动脉区域的染色，右卵巢优先受侧腔（60％），左卵巢优先受侧主动脉区域（40％）。仅在10％的病例中观察到常见的髂关节受累。在57%的案例中,腰主动脉区域的染色与悬韧带的染色有关.50%的病例涉及骨盆区,在25％的病例中出现外部iliac染色，在20％的病例中出现内部染色。
结论：我们的研究使用一种新的检测方法更好地了解卵巢的淋巴引流，并允许用现实的模型改进操作员的教学。继续这项工作可能会导致考虑更有针对性，从而减少病态淋巴结采样，用于早期卵巢癌的淋巴结分期。
方法：我们使用Simlife再循环模型将专利蓝注射到20个“血运重建”尸体卵巢的皮质中。我们观察了染料的活体迁移，并描述了每个子房的排水区域。
结果：我们观察到所有受试者的淋巴管染色和染料的迁移，系统同侧注射的卵巢。我们在65％的病例中确定了腰主动脉区域的染色，右卵巢优先受侧腔（60％），左卵巢优先受侧主动脉区域（40％）。仅在10％的病例中观察到常见的髂关节受累。在57%的案例中,腰主动脉区域的染色与悬韧带的染色有关.50%的病例涉及骨盆区,在25％的病例中出现外部iliac染色，在20％的病例中出现内部染色。
结论：我们的研究使用一种新的检测方法更好地了解卵巢的淋巴引流，并允许用现实的模型改进操作员的教学。继续这项工作可能会导致考虑更有针对性，从而减少病态淋巴结采样，用于早期卵巢癌的淋巴结分期。
