Analysis Of The Correlation Between Abnormality Of Thoracic Duct And Progression Of Secondary Lymphedema In Lower Limbs

Objective:The thoracic duct(TD)is the main channel for the return of whole body lymph fluid to the venous system.The obstruction or narrow of the TD may affect the lymph fluid reflux.The lymphedema of the lower extremity is more common in the patients with gynecological tumors or bladder cancer,often secondary to pelvic lymph node dissection and radiotherapy.There is no study to confirm the relationship between the thoracic duct abnormalities and the progression of the secondary lymphedema of the lower extremities.The article will discuss this point.Methods:Ultrasound was used to evaluate the thoracic duct walking,diameter,and patency of patients with secondary lymphedema of the lower extremities,which to analyze the correlation with the progression of the lymphedema.The Inbody composition analyzer was used to evaluate the lesioned limbs and to assess the lymphatic deposition.Results:The study included 14 patients diagnosed lower extremity lymphedema from September 2015 and September 2017 at Peking Union Medical College Hospital,of whom 6 were belonged to the TD normal group and eight patients in TD abnormality group.The average duration of disease in the TD abnormality group was 2.18±1.19 years but the another group was 8.33±2.10 years with the significant statistical difference(P=0.02).Three of eight patients in the TD abnormality group received second operation during the follow-up period,and no one return to ward in the TD normal group.Conclusion:Obstruction or narrow of the thoracic duct for the patients with the lower extremity lymphedema will accelerate the progression of the disease and effect the clinical effectiveness after operation.