Widespread anorectal lymphovascular networks and tissue drainage: analyses from submucosal India ink injection and indocyanine green fluorescence imaging

Abstract

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Anus-Preserving Surgery in Advanced Low-Lying Rectal Cancer: A Perspective on Oncological Safety of Intersphincteric Resection

“…Sato et al performed an impressive study evaluating the anorectal lymphovascular networks and tissue drainage to better understand the tumoral spread outside the rectal wall [ 157 ]. Through the use of submucosal India ink injection into fresh cadavers and resected specimens, and intra-operative indocyanine green fluorescence imaging they draw the anorectal-pelvic lymphovascular pathways.…”

Fascial Organisation and Lymphatic Systems Around the Pelvic Floor: A Literature Review

“…Although the lymphatic systems of the pelvic region remain unclear, our novel findings help researchers analyse this complex area (21). The analysed methodology may be applied to other areas in the pelvis and may contribute to future research.…”

“…India ink deposition was detected in the venous lumina and surrounding stroma of the rectal wall, and in the HL and smooth muscle fibres from the longitudinal muscle extending to the EF. These results are presented as figures in our published article (21).…”

“…Our observational study attempted to demonstrate functional anorectal lymphovascular networks (21). We performed histological examinations using a combination of immunohistochemistry, India ink injection in fresh cadavers and abdominoperineal resection specimens, and intraoperative ICG-FI in low rectal cancer cases.…”

“…This study reviewed previous analyses of the anatomical structures and lymphatic systems of the anorectal region, especially of the pelvic floor and the surrounding structures, including the LAM, HL, EF, DVF, and lateral ligament. We also reviewed our previous study, which investigated the lymphovascular network and tissue drainage in the anorectal region using India ink injections, immunohistochemistry, and intraoperative indocyanine green (ICG) -fluorescence imaging (FI) (21). This literature review aimed to clarify the anatomical structures around the pelvic floor.…”