Microlymphaticovenous Anastomosis in the Treatment of Lower Limb Obstructive Lymphedema

Gk, Huang; Rq, Hu; Zz, Liu; Yl, Shen; Td, Lan; Gp, Pan

doi:10.1097/00006534-198511000-00001

Cited by 87 publications

(6 citation statements)

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“…A non-statistically significant reduction in excess limb volume of 12.94% was observed in comparison with previously reported rates of 42.9–64.6% [37–40]. This difference in results might be explained by the fact that 80% ( n = 16) of the patients in this study came to the preoperative outpatient clinic visit wearing their stockings.…”

Section: Discussioncontrasting

confidence: 94%

Lymphatico-venous anastomosis as treatment for breast cancer-related lymphedema: a prospective study on quality of life

Cornelissen

Kool

Penha

et al. 2017

Breast Cancer Res Treat

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PurposeLymphedema is a chronic and disabling sequel of breast cancer treatment that can be treated by lymphatico-venous anastomosis (LVA). Artificial connections between the venous and lymphatic system are performed supermicrosurgically. This prospective study analyses the effect of LVA on quality of life.MethodsA prospective study was performed between November 2015 and July 2016 on consecutive patients in the Maastricht University Medical Centre. Quality of life was considered as the primary outcome, and the Lymphedema International Classification of Functioning (Lymph-ICF) questionnaire was used. Discontinuation of compressive stockings and arm volume, using the Upper Extremity Lymphedema index (UEL-index), were the secondary outcomes.ResultsTwenty women with early-stage breast cancer-related lymphedema (BCRL) were included. The mean age was 55.9 ± 4 years and the median BMI was 25.1 [21–30] kg/m2. The mean follow-up was 7.8 ± 1.5 months. Statistically significant improvement in quality of life was achieved in the total score and for all the quality of life domains after one year of follow-up (p < 0.05). The discontinuation rate in compressive stockings use was 85%. The difference in mean relative volume did not show a statistically significant decrease.ConclusionsLVA for early-stage BCRL resulted in a significant improvement in quality of life and a high rate in stocking discontinuation.

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Section: Discussioncontrasting

confidence: 94%

Lymphatico-venous anastomosis as treatment for breast cancer-related lymphedema: a prospective study on quality of life

Cornelissen

Kool

Penha

et al. 2017

Breast Cancer Res Treat

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“…6 The choice between LVA and VLNT depends on the patient's specific condition, and careful consideration by a specialized medical team is essential to determine the most suitable treatment approach. 7,45 Recently, there have been reports of combining LVA with VLNT to achieve more comprehensive lymphedema management. 8…”

Section: Comparison Between Lva and Vlntmentioning

confidence: 99%

“…The choice between LVA and VLNT depends on the patient’s specific condition, and careful consideration by a specialized medical team is essential to determine the most suitable treatment approach. 7,45…”

Section: Comparison Between Lva and Vlntmentioning

confidence: 99%

“…Over time, advancements in microsurgical techniques paved the way for more precise procedures, leading to the development of supermicrosurgical lymphovenous anastomosis (LVA), in which intima-to-intima coaptation of the collecting lymph vessels to the small veins or the venules. [5][6][7][8][9][10] Around 1970, Yamada and O'Brien reported basic studies and clinical cases of LVA, which involved the direct connection of the lymph vessels to adjacent venules or small veins using microsurgical sutures. 6 After 1980s, more reports of microvascular LVA emerged, 7,8 but still gained little popularity until 2000, Koshima et al 9 introduced the concept of supermicrosurgical anastomosis of lymphatic vessels with diameter <0.8 mm and recently, there has been a renewed interest in the surgical treatment of lymphedema.…”

mentioning

confidence: 99%

“…[5][6][7][8][9][10] Around 1970, Yamada and O'Brien reported basic studies and clinical cases of LVA, which involved the direct connection of the lymph vessels to adjacent venules or small veins using microsurgical sutures. 6 After 1980s, more reports of microvascular LVA emerged, 7,8 but still gained little popularity until 2000, Koshima et al 9 introduced the concept of supermicrosurgical anastomosis of lymphatic vessels with diameter <0.8 mm and recently, there has been a renewed interest in the surgical treatment of lymphedema. "Supermicrosurgery" means anastomosis is performed in extremely small vessels (0.3-0.8 mm in diameter).…”

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confidence: 99%

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Supermicrosurgical lymphovenous anastomosis

Lin,

Yamamoto

2024

Journal of the Chinese Medical Association

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Genital elephantiasis is a severe form of lymphedema of the groin. It is characterized by progressive enlargement and distortion of the genitals, presenting significant physical, psychological, and social challenges to the affected individuals. While pharmacological treatment of filariasis is well-established in the medical field, the surgical management of genital elephantiasis can be varied and confusing. This review article provides an in-depth analysis of the etiology, classification, severity grading, and various effective surgical treatment and reconstructive modalities commonly employed by surgeons since the early 20th Century. We also discuss how a combination approach of ablation, soft tissue coverage, and lymphatic reconstruction is viable for treating genital elephantiasis. By examining the literature, we hope to provide insights into how surgery plays a role in the holistic management of genital elephantiasis.

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Differential Diagnosis, Investigation, and Current Treatment of Lower Limb Lymphedema

Tiwari¹

2003

Arch Surg

208

153

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The causes and management of lower limb lymphedema in the Western population are different from those in the developing world. Objective: To look at the differential diagnosis, methods of investigation, and available treatments for lower limb lymphedema in the West. Data Source: A PubMed search was conducted for the years 1980-2002 with the keyword "lymphedema." English language and human subject abstracts only were analyzed, and only those articles dealing with lower limb lymphedema were further reviewed. Other articles were extracted from cross-referencing. Results: Four hundred twenty-five review articles pertaining to lymphedema were initially examined. This review summarizes the findings of relevant articles along with our own practice regarding the management of lymphedema. Conclusions: The common differential diagnosis in Western patients with lower limb swelling is secondary lymphedema, venous disease, lipedema, and adverse reaction to ipsilateral limb surgery. Lymphedema can be confirmed by a lymphoscintigram, computed tomography, magnetic resonance imaging, or ultrasound. The lymphatic anatomy is demonstrated with lymphoscintigraphy, which is particularly indicated if surgical intervention is being considered. The treatment of choice for lymphedema is multidisciplinary. In the first instance, combined physical therapy should be commenced (complete decongestive therapy), with surgery reserved for a small number of cases.

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Microlymphaticovenous Anastomosis in the Treatment of Lower Limb Obstructive Lymphedema

Cited by 87 publications

References 0 publications

Lymphatico-venous anastomosis as treatment for breast cancer-related lymphedema: a prospective study on quality of life

Lymphatico-venous anastomosis as treatment for breast cancer-related lymphedema: a prospective study on quality of life

Supermicrosurgical lymphovenous anastomosis

Differential Diagnosis, Investigation, and Current Treatment of Lower Limb Lymphedema

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