{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:36:06Z","timestamp":1792787766291,"version":"4.5.0"},"reference-count":11,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Japan Society for the Promotion of Science","award":["26463215"],"award-info":[{"award-number":["26463215"]}],"id":[{"id":"https:\/\/ror.org\/00hhkn466","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lymphatic Research and Biology"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Manual lymph drainage (MLD) is commonly used to alleviate upper limb lymphedema; however, objective evidence regarding its physiological efficacy remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study aimed to visualize postoperative changes in lymphatic flow and to identify potential collateral drainage pathways following axillary lymph node (LN) dissection using real-time fluorescent lymphography in a rat model. Twelve Wistar rats underwent surgical excision of the right axillary LNs with careful ligation of lymphatic vessels. Indocyanine green (ICG) lymphography was performed at multiple time points from day 3 to week 24 postoperatively using a photodynamic eye (PDE) imaging system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Prior to surgery, linear lymphatic signals were observed in the forelimbs. Following the surgery, these signals disappeared and were replaced by diffuse dermal backflow patterns. Over time, network-like signals developed in the axilla and progressed into linear patterns, extending toward the ipsilateral cervical region. In six of the 12 rats, the signals also reached the contralateral axillary fossa via the transverse thoracic pathways. Dermal backflow signs persisted throughout the study period despite the emergence of collateral flow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>These findings suggest that a collateral pathway to the ipsilateral cervical region may support interstitial fluid drainage in the absence of axillary lymphatic vessels. This study provides foundational insights into lymphatic rerouting mechanisms and may contribute to the future evaluation of MLD efficacy using functional imaging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15578585261497919","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T05:15:31Z","timestamp":1792473331000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Visualization of Collateral Lymphatic Pathways After Axillary Node Dissection in Rats Using Real-Time Fluorescent Lymphography"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2595-6888","authenticated-orcid":false,"given":"Yukari","family":"Takeno","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Arita","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Social Welfare Sciences, Fukui Prefectural University, Yoshida, Fukui, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chika","family":"Oshima","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Social Welfare Sciences, Fukui Prefectural University, Yoshida, Fukui, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayana","family":"Mawaki","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiya","family":"Hisano","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiori","family":"Niwa","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsuko","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"crossref","unstructured":"1.Che Bakri NA Kwasnicki RM Khan N et al. Impact of axillary lymph node dissection and sentinel lymph node biopsy on upper limb morbidity in breast cancer patients: A systematic review and meta-analysis. Ann Surg 2023;277(4):572\u2013580.","DOI":"10.1097\/SLA.0000000000005671"},{"key":"e_1_3_2_3_1","doi-asserted-by":"crossref","unstructured":"2.Executive Committee of the International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2023 consensus document of the International Society of Lymphology. Lymphology 2023;56(4):133\u2013151.","DOI":"10.2458\/lymph.6372"},{"key":"e_1_3_2_4_1","doi-asserted-by":"crossref","unstructured":"3.Williams AF Vadgama A Franks PJ Mortimer PS. A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer-related lymphoedema. Eur J Cancer Care (Engl) 2002;11(4):254\u2013261.","DOI":"10.1046\/j.1365-2354.2002.00312.x"},{"key":"e_1_3_2_5_1","doi-asserted-by":"crossref","unstructured":"4.Andersen L H\u00f8jris I Erlandsen M Andersen J. Treatment of breast-cancer-related lymphedema with or without manual lymphatic drainage: A randomized study. Acta Oncol 2000;39(3):399\u2013405.","DOI":"10.1080\/028418600750013186"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000250896.42800.a2"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.01.023"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003776"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2020.0090"},{"issue":"1","key":"e_1_3_2_10_1","first-page":"12","article-title":"Alterations of lymph flow after lymphadenectomy in rats revealed by real-time fluorescence imaging system","volume":"46","author":"Takeno Y","year":"2013","unstructured":"9.Takeno Y, , Fujimoto E. Alterations of lymph flow after lymphadenectomy in rats revealed by real-time fluorescence imaging system. Lymphology 2013;46(1):12\u201319.","journal-title":"Lymphology"},{"issue":"3","key":"e_1_3_2_11_1","first-page":"113","article-title":"Influence of age and gender on human lymphatic pumping pressure in the leg","volume":"44","author":"Unno N","year":"2011","unstructured":"10.Unno N, , Tanaka H, , Suzuki M, et al. Influence of age and gender on human lymphatic pumping pressure in the leg. Lymphology 2011;44(3):113\u2013120.","journal-title":"Lymphology"},{"issue":"3","key":"e_1_3_2_12_1","first-page":"369","article-title":"Patterns of lymphatic drainage in the adult laboratory rat","volume":"109","author":"Tilney NL","year":"1971","unstructured":"11.Tilney NL. Patterns of lymphatic drainage in the adult laboratory rat. J Anat 1971;109(Pt 3):369\u2013383.","journal-title":"J Anat"}],"container-title":["Lymphatic Research and Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15578585261497919","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15578585261497919","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15578585261497919","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T11:46:49Z","timestamp":1792756009000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15578585261497919"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":11,"alternative-id":["10.1177\/15578585261497919"],"URL":"https:\/\/doi.org\/10.1177\/15578585261497919","relation":{},"ISSN":["1539-6851","1557-8585"],"issn-type":[{"value":"1539-6851","type":"print"},{"value":"1557-8585","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]},"article-number":"15578585261497919"}}