Lymphaticovenular anastomoses for lymphedema treatment: 18 months postoperative outcomes

Aubá, Cristina; Marré, Diego; Rodriguez-Losada, Gonzalo; Hontanilla, Bernardo

doi:10.1002/micr.20980

Cited by 69 publications

(63 citation statements)

References 35 publications

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“…In 'microsurgical lymphaticovenous anastomosis’, lymphatic vessels with surrounding tissue are inserted into a vein (>2 mm), and anastomosis site thrombosis is inevitable when venous reflux occurs. In 'supermicrosurgical lymphaticovenular anastomosis’, a lymphatic vessel is anastomosed to a venule or smaller vein (approximately 0.5 mm) in an intima-to-intima coaptation manner and can prevent anastomosis site thrombosis even when venous reflux occurs [129-140]. This method is based on two concepts.…”

Section: Reviewmentioning

confidence: 99%

“…In the largest retrospective study of 1,800 patients over 10 years, Campisi demonstrates a volume reduction of 67% and notes that 85% of patients were able to discontinue conservative treatment modalities [134]. Disadvantages to this procedure are that it is technically challenging and results are currently unpredictable [140]. Advantages of lymphaticovenular bypass include minimal invasiveness and a low rate of complications [131].…”

Section: Reviewmentioning

confidence: 99%

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Breast and gynecologic cancer-related extremity lymphedema: a review of diagnostic modalities and management options

et al. 2013

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Lymphedema remains a poorly understood entity that can occur after lymphadenectomy. Herein, we will review the pathogenesis of lymphedema, diagnostic modalities and the natural history of extremity involvement. We will review the incidence of upper extremity lymphedema in patients treated for breast malignancies and lower extremity lymphedema in those treated for gynecologic malignancy. Finally, we will review traditional treatment modalities for lymphedema, as well as introduce new surgical treatment modalities that are under active investigation.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Breast and gynecologic cancer-related extremity lymphedema: a review of diagnostic modalities and management options

et al. 2013

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“…LVA is generally performed for lymphedema . In addition, based on our experience in the present case, LVA may be considered useful in treating intractable ulcers due to lymphostasis .…”

Section: Discussionmentioning

confidence: 72%

The effect of lymphatico-venous anastomosis for an intractable ulcer at the lower leg in a marked obese patient

et al. 2013

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Secondary lymphedema occurs after trauma, cancer surgery, or obesity, and wounds in lymphedema can easily become intractable. We report positive results using lymphatico-venous anastomosis (LVA) to treat a post-traumatic lymph fistula and an intractable ulcer in a severely obese patient. A 41-year-old male (BMI 51.8), one year prior, had a traffic injury, and had an 18-cm contusion in his right leg. Six months later, lymph leakage in a 14 cm 3 8 cm region and a 5 cm 3 3 cm skin ulcer occurred in the center of the wound. We made a diagnosis of lymphedema resulting from obesity, accompanied with lymphorrhea and intractable ulcer. He was unable to reach his legs owing to obesity, making complex physical therapy impossible. We performed LVA under local anesthesia. The lymphorrhea healed 2 weeks after the operation and had not recurred 3 months after the operation. The leg lymphedema improved after the surgery without the compression therapy. In cases of intractable ulcers, suspected of being caused by lymphostasis, treatments indicated for lymphedema, for example LVA, may possibly allow satisfactory wound healing.

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“…The condition is difficult to treat in many cases because it recurs in the same or a different region after simple resection. Recently, surgical procedures like lymphatico‐venous anastomosis (LVA) are reported to be effective for lymphedema . Yamamoto et al achieved a favorable outcome using LVA applied at several sites of the lower limb for treatment of lymphatic fistula complicating lower limb lymphedema, but LVA alone is not always effective.…”

mentioning

confidence: 99%

Therapeutic strategy for lower limb lymphedema and lymphatic fistula after resection of a malignant tumor in the hip joint region: A case report

et al. 2013

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Lymphatic fistula complicating lymphedema is thought to occur due to communication between lymph vessels and the skin, which has yet to be shown objectively. The objective of this case report is to show the pathology and treatment using simultaneous lymphatic fistula resection and lymphatico-venous anastomosis (LVA). A 40-year-old woman underwent extended resection and total hip arthroplasty for primitive neuroectodermal tumor in the right proximal femur 23 years ago. Right lower limb lymphedema developed immediately after surgery and lymphatic fistula appeared in the posterior thigh. On ICG lymphography, lymph reflux toward the distal side dispersing in a fan-shape reticular pattern from the lymphatic fistula region was noted after intracutaneous injection of ICG into the foot. We performed simultaneous lymphatic fistula resection and of LVA. Pathological examination showed that the epidermis and stratum corneum of the healthy skin were lost in the lymphatic fistula region. Dilated lymph vessels were open in this region. The examinations provide the first objective evidence that the cause of lymphatic fistula may be lymph reflux from lymphatic stems to precollectors through lymphatic perforators.

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Lymphaticovenular anastomoses for lymphedema treatment: 18 months postoperative outcomes

Cited by 69 publications

References 35 publications

Breast and gynecologic cancer-related extremity lymphedema: a review of diagnostic modalities and management options

Breast and gynecologic cancer-related extremity lymphedema: a review of diagnostic modalities and management options

The effect of lymphatico-venous anastomosis for an intractable ulcer at the lower leg in a marked obese patient

Therapeutic strategy for lower limb lymphedema and lymphatic fistula after resection of a malignant tumor in the hip joint region: A case report

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