{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T08:36:34Z","timestamp":1770453394776,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,8,10]],"date-time":"2019-08-10T00:00:00Z","timestamp":1565395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pelvic lymphadenectomy (PL) causes changes to the inguinal lymph nodes with progressive loss of immune and lymphatic pump function. Efferent lymphatic vessel\u2010to\u2010venous anastomosis (ELVA) has been reported to address this problem. The aim of this report was to describe the feasibility of the SPECT\/CT combined with ultrasound fusion imaging (UFI) to target the groin efferent lymph node (GELN) for ELVA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Twelve patients with lower limb lymphedema after PL were scheduled for peripheric lymphaticovenular anastomosis (LVA) combined with ELVA. All\u2010patients were clinically ISL\u2010stage1, with good visualization of the inguinal lymph nodes at preoperative lymphoscintigraphy. The mean patient age was 55.4\u2009years and the mean BMI was 25.5.The mean limb circumference (MLC) was calculated before surgery and 1\u2009year after surgery. The LymQoL\u2010Leg questionnaire was administered before surgery and 6 months after surgery. Before surgery, the GELN was identified by SPECT\/CT and its location was marked on the skin by UFI virtual navigation. Peripheric LVA sites were planned by ultrasound and indocyanine green (ICG) lymphography. Pre and postoperative MLC and LymQoL\u2010Leg scores were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all\u2010patients, the SPECT\/CT succeeded at detecting and targeting the GELN. In all\u2010patients, real\u2010time anatomical coregistration with US was feasible, and it was possible to mark on the groin skin the depth and position of the GELN on the skin at the groin. During surgery, in every patient, we found the GELN marked before surgery and performed ELVA. We also performed two or three peripheric LVAs in every patient. The mean value of MLC decreased (38.2\u2009\u00b1\u20092.13\u2009cm vs. 36.33\u2009\u00b1\u20092.14\u2009cm; <jats:italic>p<\/jats:italic> = .04) and the mean score of the LymQoL\u2010Leg questionnaire improved (9.3\u2009\u00b1\u20091.7 vs. 7.7\u2009\u00b1\u20091.1; <jats:italic>p<\/jats:italic> = .02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SPECT\/CT combined with UFI is feasible for the preoperative identification of GELN for ELVA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30501","type":"journal-article","created":{"date-parts":[[2019,8,10]],"date-time":"2019-08-10T12:11:25Z","timestamp":1565439085000},"page":"605-612","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["SPECT\/CT and fusion ultrasound to target the efferent groin lymph node for lymphatic surgery"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9682-4706","authenticated-orcid":false,"given":"Stefano","family":"Gentileschi","sequence":"first","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze Della Salute Della Donna E Del Bambino E Di Sanit\u00e0 Pubblica Unit\u00e0 di Chirurgia Plastica  Roma Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore Istituto di Clinica Chirurgica  Roma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Albanese","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore Istituto di Clinica Chirurgica  Roma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Pino","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore Istituto di Clinica Chirurgica  Roma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluigi","family":"Stefanizzi","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze Della Salute Della Donna E Del Bambino E Di Sanit\u00e0 Pubblica Unit\u00e0 di Chirurgia Plastica  Roma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Fragomeni","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS Dipartimento Scienze Della Salute Della Donna E Del Bambino E Di Sanit\u00e0 Pubblica  Roma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Zagaria","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS Dipartimento Diagnostica per Immagini Radioterapia oncologica ed Ematologia  Roma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco P.","family":"Ieria","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Cristo Re Hospital  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marzia","family":"Salgarello","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze Della Salute Della Donna E Del Bambino E Di Sanit\u00e0 Pubblica Unit\u00e0 di Chirurgia Plastica  Roma Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore Istituto di Clinica Chirurgica  Roma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Scambia","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. 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