Multisite Lymphaticovenular Bypass Using Supermicrosurgery Technique for Lymphedema Management in Lower Lymphedema Cases
| Autor: | Han Peng Zhou, Hisako Hara, Mari Kawahara, Makoto Mihara, Noriyuki Murai, Yohei Shimizu, Shuichi Tange |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Indocyanine Green Male medicine.medical_specialty Microsurgery 030230 surgery Anastomosis Lower limb 03 medical and health sciences Young Adult 0302 clinical medicine hemic and lymphatic diseases Medicine Humans Lymphedema Coloring Agents Aged Lymphatic Vessels Retrospective Studies Aged 80 and over business.industry Anastomosis Surgical Follow up studies Lymphography Retrospective cohort study Middle Aged medicine.disease humanities Surgery Lymphaticovenous anastomosis body regions Treatment Outcome Lower Extremity Clinical evidence Male patient 030220 oncology & carcinogenesis Female business Vascular Surgical Procedures Lymphoscintigraphy Follow-Up Studies |
| Zdroj: | Plastic and reconstructive surgery. 138(1) |
| ISSN: | 1529-4242 |
| Popis: | The impact of lymphaticovenous anastomosis on lymphedema has yet to be defined. The authors investigated the clinical evidence regarding the effectiveness of lymphaticovenous anastomosis in lower limb lymphedema.Eighty-four patients (162 limbs; 73 female and 11 male patients) with lower limb lymphedema who underwent multisite lymphaticovenous anastomosis in the authors' clinic between August of 2010 and May of 2014 were included in this retrospective study. Lymphedema was diagnosed using lymphoscintigraphy and indocyanine green lymphography. All lymphaticovenous anastomoses were performed under local anesthesia. The lymphatic vessels that were identified were classified using the normal, ectasis, contraction, and sclerosis type (NECST) classification. Limb circumference, subjective symptoms, and frequency of cellulitis were evaluated.The average patient age was 60 years (range, 24 to 94 years); mean postoperative follow-up period was 18.3 months (range, 6 to 51 months). The postoperative change rate in limb circumference indicated that 67 limbs (47.7 percent) were classified as improved, 35 (27.3 percent) were classified as stable, and 32 (25 percent) were classified as worse. Postoperative interview revealed improvement in subjective symptoms in 67 limbs (61.5 percent), no change in 38 (34.9 percent), and exacerbation in four (3.7 percent). The postoperative mean occurrence of cellulitis was decreased to 0.13 times per year compared with 0.89 preoperatively, which was statistically significant (p = 0.00084). Multiple regression analysis using the postanastomosis limb circumference and NECST classification confirmed the following results: change rate (percent) = -0.40 + (0.30 × N) + (-0.84 × E) + (0.22 × C) + (-0.61 × S).Lymphaticovenous anastomosis is effective for lower limb lymphedema, in point of limb circumference, subjective symptoms, and the frequency of cellulitis.Therapeutic, IV. |
| Databáze: | OpenAIRE |
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