Scarless lymphatic venous anastomosis for latent and early-stage lymphoedema using indocyanine green lymphography and non-invasive instruments for visualising subcutaneous vein
| Autor: | Takuya Iida, Noriyuki Murai, Mitsunaga Narushima, Isao Koshima, Makoto Mihara, Guido Gabriele, Jun Araki, Takumi Yamamoto, Hisako Hara, Kito Mitsui, Kazuki Kikuchi, Paolo Gennaro |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Adult
Indocyanine Green medicine.medical_specialty accuvein icg lymphography lva lymphatic venous anastomosis lymphoscintigraphy statvein supermicrosurgery Anastomosis Uterine Cervical Neoplasms Accuvein ICG lymphography LVA Lymphatic venous anastomosis Lymphoscintigraphy Statvein Supermicrosurgery Aged Anastomosis Surgical Coloring Agents Female Humans Leg Lymphedema Lymphography Middle Aged Treatment Outcome Surgery chemistry.chemical_compound Surgical medicine Stage (cooking) Vein integumentary system business.industry medicine.disease body regions Lymphatic system medicine.anatomical_structure chemistry Lymph circulation Lymph business Indocyanine green |
| Popis: | Summary Background Lymphoedema can be treated conservatively or surgically. Early treatment is important, but the surgical indication and the effect of surgery on pain in lymphoedema-affected limbs have not been described. The objective of this study was to examine the effect of low-invasive scarless lymphatic venous anastomosis (LVA) for early or latent lymphoedema. Methods LVA was performed in six patients (eight legs) with leg lymphoedema between April 2010 and March 2011. Lymphoedema was stage 0 (defined as subclinical) in three patients (five legs) and stage 1 in three patients (three legs). Subjective symptoms, circumference of the affected leg and a lymphoscintigram were evaluated before and 6 months after surgery. Preoperatively, subcutaneous lymph vessels and veins were identified non-invasively using ICG lymphoscintigraphy and non-invasive instruments for visualising subcutaneous vein, AccuVein system, through the skin. These vessels and veins were secured with vessel loops passed underneath and side-to-side anastomosed under a surgical microscope. Results Subjective symptoms improved after surgery in all patients. The leg circumference improved in stage 1 cases, which all had an increased circumference before surgery. Lymph retention was observed on preoperative lymphoscintigraphy in all six patients and was improved after surgery in all cases. Conclusions Scarless LVA performed through a small incision improves abnormal lymph circulation and subjective symptoms in cases of early lymphoedema, in which the limb circumference has just started to increase, and latent lymphoedema, in which the circumference has not increased, but abnormal findings on lymphoscintigraphy or subjective symptoms are present. |
| Databáze: | OpenAIRE |
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