Applied anatomy of the lymphatic vessels alongside the small saphenous vein
CHEN Yuan, BO Wei-Ren, WANG De-An, CENG Fan-Jiang
Chinese Journal of Clinical Anatomy ›› 2014, Vol. 32 ›› Issue (4) : 412-415.
Applied anatomy of the lymphatic vessels alongside the small saphenous vein
Objective To determine the lymphatic anatomy around the small saphenous vein (SSV). Methods Six legs harvested from three unembalmed human cadavers were studied. Under a surgical microscope, a mixture of 6% hydrogen peroxide was used to detect the lymphatic vessels commencing in the skin between the lateral malleolus and the Achilles tendon. A 30-gauge needle was inserted into the lymphatic vessel and injected with a radio-opaque barium sulphate or lead oxide mixture. The vessels around SSV were traced, photographed and radiographed. Results Two collecting lymphatic vessels were found along SSV, one on each side. They originated beneath the dermis between the lateral malleolus and the Achilles tendon and some of them from the posteroinferior part of the leg. The vessels travelled tortuously in the subcutaneous tissue on each side of SSV and pierced the deep fascia in the posterosuperior part of the leg to enter the popliteal fossa. They then divided into small branches before entering the popliteal lymph nodes. The diameters of the vessels varied from 0.3 to 1.5 mm, larger in the proximal side and smaller in the distal end. Conclusion Actual and accurate lymphatic anatomy of the human extrimities has been described. This information can improve our anatomical knowledge and the results will be of bene?t for clinical management and further studies in the region.
Lymphatic vessel / Small saphenous vein / Lymphedema / Lymphaticovenular anastomosis / Lymphatic grafting
[1] Aselli G. De lactibus sine lacteis venis
[M]. Italy: Milan, 1627: 1-103.
[2] Haagensen CD, Feind CR, Herter FP, et al. The lymphatics in cancer
[M]. Philadelphia: WB Saunders, 1972: 1-22.
[3] Cruikshank W. The anatomy of the absorbing vessels of the human body
[M]. London: G. Nicol, 1786: 1-210.
[4] Bonamy C, Broca P, Beau ME. Atlas d’anatomie descriptive du corps humain
[M]. Paris: Victor Masson, 1850: PI43-54.
[5] Sappey PC. Anatomie, Physiologie, Pathologie des vaisseaux lymphatiques
[M]. Paris: Adrien Delahaye, 1874:1-134.
[6] Gerota D. Zur technik der lymphgefassinjection. Eine neue injections-masse fur lymphgefasse. Polychrom injection
[J]. Anat Anzeiger, 1896, 12: 216-224.
[7] Bartel B. Das Lymphgefasssystem. In Handbuch der Anatomie des Menschen
[M]. Edited by Kv Bardeleben. Jene: Gustav Fischer, 1909:1-250.
[8] Rouvière H. Anatomy of the human lymphatic system
[M]. Translated by Tobias MJ. Michgan: Edwards Brothers Inc., 1938: 1-302.
[9] Málek P, Kolc J, Belán A. Lymphography of the deep lymphatic system of the thigh
[J]. Acta Radiol, 1959,(51): 422-428.
[10] Viamonte MJ, Rüttimann A. Atlas of Lymphography
[M]. New York: Thieme, 1980：8-201.
[11] 刘牧之,钟世镇. 人体淋巴系统解剖图谱写
[M]. 北京：科学出版社，1982: 201, 207-210.
[12]王云祥. 实用淋巴系统解剖学
[M]. 北京：人民卫生出版社，1984: 67-71, 263-278.
[13]刘执玉，毕玉顺，田华，等. 淋巴的基础与临床
[M]. 北京：科学出版社，2003：71-80, 266-280.
[14]Pan WR, Wang DG, Levy SM, et al. Superficial lymphatic drainage of the lower extremity: anatomic study and clinical implications
[J]. Plast Reconstr Surg,2013, 132(3): 696-707.
[15]Huang GK, Hu RQ, Liu ZZ, et al. Microlymphaticovenous anastomosis in the treatment of lower limb obstructive lymphedema: analysis of 91 cases
[J]. Plast Reconstr Surg,1985, 76(5): 671-677.
[16]Gloviczki P, Fisher J, Holloer LH,et al. Microsurgical lymphovenous anastomosis for treatment of lymphedema: A critical review
[J]. J Vasc Sur, 1988, 7(5): 647-652.
[17]O'Brien BM, Mellow CG, Khazanchi RK, et al. Long-Term Results after Microlymphaticovenous anastomoses for the treatment of obstructive lymphedema
[J]. Plast Reconstr Surg, 1990, 85(4): 562-572.
[18]Koshima I, Nanba Y, Tsutsui T, et al. Long-term follow-up after lymphaticovenular anastomosis for lymphedema in the leg
[J]. J Reconstr Microsurg, 2003, 19(4): 209-215.
[19]Demirtas Y, Ozturk N, Yapici O, et al. Supermicrosurgical lymphaticovenular anastomosis and lymphaticovenous implantation for treatment of unilateral lower extremity lymphedema
[J]. Microsurgery, 2009, 29(8): 609-618.
[20]Baumeister R, Siuda S. Treatment of lymphedemas by microsurgical lymphatic grafting : what is proved
[J]? Plast Reconstr Surg, 1990, 85(1): 64-74.
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