Ultrasonography for classifying lymphatic sclerosis types and deciding optimal sites of lymphatic-venous anastomosis in lymphoedema patients

We have previously categorised the degree of degeneration of the collecting lymphatic vessels into four types: normal, ectasis, contraction and sclerosis type (NECST classification). Here, we evaluated the collective lymphatic vessels in lymphoedema-affected limbs using ultrasonography. In step 1, we investigated 110 lymphatic vessels from 25 patients with lymphoedema, who underwent lymphatic-venous anastomosis (LVA) following preoperative ultrasonography. We classified the lymphatic vessels using the NECST classification via intraoperative microscopic observation.