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논문 기본 정보

자료유형
학술저널
저자정보
Suzuki, Yushi (Department of Plastic and Reconstructive Surgery, University of the Ryukyus) Sakuma, Hisashi (Department of Plastic and Reconstructive Surgery, Yokohama Municipal Citizen's Hospital) Ihara, Jun (Department of Plastic and Reconstructive Surgery, Sano Kosei General Hospital) Shimizu, Yusuke (Department of Plastic and Reconstructive Surgery, University of the Ryukyus)
저널정보
대한성형외과학회 Archives of plastic surgery : APS Archives of plastic surgery : APS 제46권 제4호
발행연도
2019.1
수록면
344 - 349 (6page)

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Background Lymphaticovenous anastomosis is an important surgical treatment for lymphedema, with lymphaticovenous side-to-end anastomosis (LVSEA) and lymphaticovenous end-to-end anastomosis being the most frequently performed procedures. However, LVSEA can cause lymphatic flow obstruction because of regurgitation and tension in the anastomosis. In this study, we introduce a novel and simple procedure to overcome this problem. Methods Thirty-five female patients with lower extremity lymphedema who underwent lymphaticovenous anastomosis at our hospital were included in this study. Eighty-five LVSEA procedures were performed, of which 12 resulted in insufficient venous blood flow. For these 12 anastomoses, the proximal lymphatic vessel underwent clipping after the anastomotic procedure and the venous inflow was monitored. Subsequently, the proximal ligation after side-to-end anastomosis recovery (PLASTER) technique, which involves ligating the proximal side of the lymphatic vessel, was applied. A postoperative evaluation was performed using indocyanine green 6 months after surgery. Results Despite the clipping procedure, three of the 12 anastomoses still showed poor venous inflow. Therefore, it was not possible to apply the PLASTER technique in those cases. Among the nine remaining anastomoses in which the PLASTER technique was applied, three (33%) were patent. Conclusions Our findings show that achieving patent anastomosis is challenging when postoperative venous inflow is poor. We achieved good results by performing proximal ligation after LVSEA. Thus, the PLASTER technique is a particularly useful recovery technique when LVSEA does not result in good run-off.
#Microsurgery #Lymphatic vessels #Edema #Lymphatic diseases

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참고문헌 (15)

참고문헌 신청
Masia J / 2014 / Barcelona consensus on supermicrosurgery / J Reconstr Microsurg 30:53~58 google schola Cheng MH / 2016 / Principles and practice of lymphedema surgery / Elsevier google schola Maegawa J / 2012 / Outcomes of lymphaticovenous side-to-end anastomosis in peripheral lymphedema / J Vasc Surg 55:753~760 google schola Suzuki Y / 2019 / Evaluation of patency rates of different lymphaticovenous anastomosis techniques and risk factors for obstruction in secondary upper extremity lymphedema / J Vasc Surg Venous Lymphat Disord 7:113~117 google schola Suzuki Y / 2019 / Comparison of patency rates of lymphaticovenous anastomoses at different sites for lower extremity lymphedema / J Vasc Surg Venous Lymphat Disord 7:222~227 google schola

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