Lymph Node to Vein Anastomosis (LNVA) for lower extremity lymphedema
| Autor: | Min-Jeong Cho, Chang Sik Pak, Joon Pio Hong, Hyunsuk Peter Suh, Jin Geun Kwon |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Microsurgery 030230 surgery Anastomosis 03 medical and health sciences 0302 clinical medicine Extracellular fluid medicine Humans Lymphedema Vein Lymph node Aged Lymphatic Vessels Retrospective Studies business.industry Lower extremity lymphedema Anastomosis Surgical Retrospective cohort study Middle Aged medicine.disease Magnetic Resonance Imaging Surgery medicine.anatomical_structure Lower Extremity 030220 oncology & carcinogenesis Body Composition Female Lymph Lymph Nodes business |
| Zdroj: | Journal of plastic, reconstructiveaesthetic surgery : JPRAS. 74(9) |
| ISSN: | 1878-0539 |
| Popis: | Summary The microsurgical options for lower limb lymphedema is a challenge. In search to improve the overall result, we hypothesized it would be beneficial to add the functioning lymph nodes to vein anastomosis (LNVA) in addition to lymphovenous anastomosis (LVA). This is a retrospective study of 160 unilateral stage II & III lower extremity lymphedema comparing the outcome between the LNVA + LVA group and the LVA only group from May 2013 to June 2018. MRI was used to identify the functioning lymph nodes. Patient outcome, including lower extremity circumference, body weight, bio impedance test, and other data were analyzed to evaluate whether lymph nodes to vein anastomosis (LNVA) improved outcome. The LNVA + LVA group showed significantly better results for circumference reduction rate, body weight reduction rate, and extracellular fluid reduction rate of the affected limb as compared to the LVA only group for both stage II and III lymphedema. The MRI imaging revealed that 9 cases had no identifiable lymph nodes of the affected limb and 54 cases with a nonfunctioning lymph node upon exploration despite positive imaging. Correlation showed the lymph node size needed to be at least 8 mm in the MRI to be functional. The LNVA + LVA approach for lymphedema has the benefit of better reduction as compared to LVA alone in the lower limb as well as the suprapubic region. Preoperative MRI will help to identify the functioning lymph node by increasing the overall probability of positive outcome. |
| Databáze: | OpenAIRE |
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