Side-to-End Lymphaticovenular Anastomosis through Temporary Lymphatic Expansion
Identifieur interne : 003158 ( Main/Exploration ); précédent : 003157; suivant : 003159Side-to-End Lymphaticovenular Anastomosis through Temporary Lymphatic Expansion
Auteurs : Takumi Yamamoto (chirurgien) [Japon] ; Hidehiko Yoshimatsu ; Nana Yamamoto ; Mitsunaga Narushima ; Takuya Iida ; Isao KoshimaSource :
- PLoS ONE [ 1932-6203 ] ; 2013.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Membre inférieur.
- Adulte, Adulte d'âge moyen, Anastomose chirurgicale, Femelle, Humains, Lymphoedème, Mâle, Résultat thérapeutique, Sujet âgé, Vaisseaux lymphatiques.
English descriptors
- KwdEn :
- MESH :
- methods : Anastomosis, Surgical.
- pathology : Lower Extremity.
- surgery : Lymphatic Vessels, Lymphedema.
- therapy : Lymphedema.
- Adult, Aged, Female, Humans, Male, Middle Aged, Treatment Outcome.
Abstract
The number of bypasses is the most important factor in lymphaticovenular anastomosis (LVA) for lymphedema treatment. Side-to-end (S-E) LVA, which can bypass bidirectional lymph flows via one anastomosis, is considered to be the most efficient bypass, but creation of lateral window to a small lymphatic vessel is technically demanding. To overcome the difficulty, we introduced S-E anastomosis through temporary lymphatic expansion (SEATTLE) procedure in S-E LVA.
This was a retrospective observational study set in a teaching hospital. Forty eight lower extremity lymphedema (LEL) patients underwent LVA. S-E LVAs were performed with (SEATTLE group) or without (non-SEATTLE group) temporary lymphatic expansion. S-E LVAs were evaluated to compare anastomosis result in SEATTLE and non-SEATTLE groups.
S-E LVAs resulted in 44 anastomoses in SEATTLE group (n = 25) and 37 anastomoses in non-SEATTLE group (n = 23). LEL index reduction in SEATTLE group was significantly greater than that in non-SEATTLE group (16.5±14.5 vs. 10.9±11.8,
The SEATTLE procedure facilitates S-E LVA by a simple and easy maneuver. When the diameter of the lymphatic vessel is 0.35 mm or smaller even after the temporary lymphatic expansion maneuver, S-E LVA is not recommended due to relatively high failure rate.
Url:
DOI: 10.1371/journal.pone.0059523
PubMed: 23536881
PubMed Central: 3607574
Affiliations:
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sortKey="Narushima, Mitsunaga" sort="Narushima, Mitsunaga" uniqKey="Narushima M" first="Mitsunaga" last="Narushima">Mitsunaga Narushima</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Iida, Takuya" sort="Iida, Takuya" uniqKey="Iida T" first="Takuya" last="Iida">Takuya Iida</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Koshima, Isao" sort="Koshima, Isao" uniqKey="Koshima I" first="Isao" last="Koshima">Isao Koshima</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23536881</idno><idno type="pmc">3607574</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3607574</idno><idno type="RBID">PMC:3607574</idno><idno type="doi">10.1371/journal.pone.0059523</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">004470</idno><idno type="wicri:explorRef" wicri:stream="Pmc" 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Nana" sort="Yamamoto, Nana" uniqKey="Yamamoto N" first="Nana" last="Yamamoto">Nana Yamamoto</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Narushima, Mitsunaga" sort="Narushima, Mitsunaga" uniqKey="Narushima M" first="Mitsunaga" last="Narushima">Mitsunaga Narushima</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Iida, Takuya" sort="Iida, Takuya" uniqKey="Iida T" first="Takuya" last="Iida">Takuya Iida</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Koshima, Isao" sort="Koshima, Isao" uniqKey="Koshima I" first="Isao" last="Koshima">Isao Koshima</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Anastomosis, Surgical (methods)</term><term>Female</term><term>Humans</term><term>Lower Extremity (pathology)</term><term>Lymphatic Vessels (surgery)</term><term>Lymphedema (surgery)</term><term>Lymphedema (therapy)</term><term>Male</term><term>Middle Aged</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Anastomose chirurgicale ()</term><term>Femelle</term><term>Humains</term><term>Lymphoedème ()</term><term>Membre inférieur (anatomopathologie)</term><term>Mâle</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Vaisseaux lymphatiques ()</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Membre inférieur</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Anastomosis, Surgical</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Lower Extremity</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Lymphatic Vessels</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Anastomose chirurgicale</term><term>Femelle</term><term>Humains</term><term>Lymphoedème</term><term>Mâle</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Vaisseaux lymphatiques</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>The number of bypasses is the most important factor in lymphaticovenular anastomosis (LVA) for lymphedema treatment. Side-to-end (S-E) LVA, which can bypass bidirectional lymph flows via one anastomosis, is considered to be the most efficient bypass, but creation of lateral window to a small lymphatic vessel is technically demanding. To overcome the difficulty, we introduced S-E anastomosis through temporary lymphatic expansion (SEATTLE) procedure in S-E LVA.</p></sec><sec><title>Methods</title><p>This was a retrospective observational study set in a teaching hospital. Forty eight lower extremity lymphedema (LEL) patients underwent LVA. S-E LVAs were performed with (SEATTLE group) or without (non-SEATTLE group) temporary lymphatic expansion. S-E LVAs were evaluated to compare anastomosis result in SEATTLE and non-SEATTLE groups.</p></sec><sec><title>Results</title><p>S-E LVAs resulted in 44 anastomoses in SEATTLE group (n = 25) and 37 anastomoses in non-SEATTLE group (n = 23). LEL index reduction in SEATTLE group was significantly greater than that in non-SEATTLE group (16.5±14.5 vs. 10.9±11.8, <italic>P</italic> = 0.041). Success rate of S-E LVA in SEATTLE group was significantly higher than that in non-SEATTLE group (95.5% vs 81.1%, <italic>P</italic> = 0.040). Thirty seven of 44 (84.1%) lymph vessels in SEATTLE group were successfully dilated by temporary lymphatic expansion maneuver. All of 9 failed S-E LVAs used a lymphatic vessel with diameter of 0.35 mm or smaller.</p></sec><sec><title>Conclusions</title><p>The SEATTLE procedure facilitates S-E LVA by a simple and easy maneuver. When the diameter of the lymphatic vessel is 0.35 mm or smaller even after the temporary lymphatic expansion maneuver, S-E LVA is not recommended due to relatively high failure rate.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Szuba, A" uniqKey="Szuba A">A Szuba</name></author><author><name sortKey="Cooke, Jp" uniqKey="Cooke J">JP Cooke</name></author><author><name sortKey="Yousuf, S" uniqKey="Yousuf S">S Yousuf</name></author><author><name sortKey="Rockson, Sg" uniqKey="Rockson S">SG Rockson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Warren, Ag" uniqKey="Warren A">AG Warren</name></author><author><name sortKey="Brorson, H" uniqKey="Brorson H">H Brorson</name></author><author><name sortKey="Borud, Lj" uniqKey="Borud L">LJ Borud</name></author><author><name sortKey="Slavin, Sa" uniqKey="Slavin S">SA Slavin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Armer, J" uniqKey="Armer J">J Armer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Devoogdt, N" uniqKey="Devoogdt N">N Devoogdt</name></author><author><name sortKey="Van, Km" uniqKey="Van K">KM Van</name></author><author><name sortKey="Geraerts, I" uniqKey="Geraerts I">I Geraerts</name></author><author><name sortKey="Coremans, T" uniqKey="Coremans T">T Coremans</name></author><author><name sortKey="Christiaens, Mr" uniqKey="Christiaens M">MR Christiaens</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mcneely, Ml" uniqKey="Mcneely M">ML McNeely</name></author><author><name sortKey="Peddle, Cj" uniqKey="Peddle C">CJ Peddle</name></author><author><name sortKey="Yurick, Jl" uniqKey="Yurick J">JL Yurick</name></author><author><name sortKey="Dayes, Is" uniqKey="Dayes I">IS Dayes</name></author><author><name sortKey="Mackey, Jr" uniqKey="Mackey J">JR Mackey</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamada, Y" uniqKey="Yamada Y">Y Yamada</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koshima, I" uniqKey="Koshima I">I Koshima</name></author><author><name sortKey="Inagawa, K" uniqKey="Inagawa K">K Inagawa</name></author><author><name sortKey="Urushibara, K" uniqKey="Urushibara K">K Urushibara</name></author><author><name sortKey="Moriguchi, T" uniqKey="Moriguchi T">T Moriguchi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koshima, I" uniqKey="Koshima I">I Koshima</name></author><author><name sortKey="Nanba, Y" uniqKey="Nanba Y">Y Nanba</name></author><author><name sortKey="Tsutsui, T" uniqKey="Tsutsui T">T Tsutsui</name></author><author><name sortKey="Takahashi, Y" uniqKey="Takahashi Y">Y Takahashi</name></author><author><name sortKey="Itoh, S" uniqKey="Itoh S">S Itoh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koshima, I" uniqKey="Koshima I">I Koshima</name></author><author><name sortKey="Nanba, Y" uniqKey="Nanba Y">Y Nanba</name></author><author><name sortKey="Tsutsui, T" uniqKey="Tsutsui T">T Tsutsui</name></author><author><name sortKey="Takahashi, Y" uniqKey="Takahashi Y">Y Takahashi</name></author><author><name sortKey="Itoh, S" uniqKey="Itoh S">S Itoh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nagase, T" uniqKey="Nagase T">T Nagase</name></author><author><name sortKey="Gonda, K" uniqKey="Gonda K">K Gonda</name></author><author><name sortKey="Inoue, K" uniqKey="Inoue K">K Inoue</name></author><author><name sortKey="Higashino, T" uniqKey="Higashino T">T Higashino</name></author><author><name sortKey="Fukuda, N" uniqKey="Fukuda N">N Fukuda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Narushima, M" uniqKey="Narushima M">M Narushima</name></author><author><name sortKey="Mihara, M" uniqKey="Mihara M">M Mihara</name></author><author><name sortKey="Yamamoto, Y" uniqKey="Yamamoto Y">Y Yamamoto</name></author><author><name sortKey="Iida, T" uniqKey="Iida T">T Iida</name></author><author><name sortKey="Koshima, I" uniqKey="Koshima I">I Koshima</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chang, Dw" uniqKey="Chang D">DW Chang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamamoto, T" uniqKey="Yamamoto T">T Yamamoto</name></author><author><name sortKey="Narushima, M" uniqKey="Narushima M">M Narushima</name></author><author><name sortKey="Kikuchi, K" uniqKey="Kikuchi K">K Kikuchi</name></author><author><name sortKey="Yoshimatsu, H" uniqKey="Yoshimatsu H">H Yoshimatsu</name></author><author><name sortKey="Todokoro, T" uniqKey="Todokoro T">T Todokoro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamamoto, T" uniqKey="Yamamoto T">T Yamamoto</name></author><author><name sortKey="Koshima, I" uniqKey="Koshima I">I Koshima</name></author><author><name sortKey="Yoshimatsu, H" uniqKey="Yoshimatsu H">H Yoshimatsu</name></author><author><name sortKey="Narushima, M" uniqKey="Narushima M">M Narushima</name></author><author><name sortKey="Mihara, M" uniqKey="Mihara M">M Mihara</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Yamamoto, T" uniqKey="Yamamoto T">T Yamamoto</name></author><author><name sortKey="Narushima, M" uniqKey="Narushima M">M Narushima</name></author><author><name sortKey="Doi, K" uniqKey="Doi K">K Doi</name></author><author><name sortKey="Oshima, A" uniqKey="Oshima A">A Oshima</name></author><author><name sortKey="Ogata, F" uniqKey="Ogata F">F Ogata</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamamoto, T" uniqKey="Yamamoto T">T Yamamoto</name></author><author><name sortKey="Iida, T" uniqKey="Iida T">T Iida</name></author><author><name sortKey="Matsuda, N" uniqKey="Matsuda N">N Matsuda</name></author><author><name sortKey="Kikuchi, K" uniqKey="Kikuchi K">K Kikuchi</name></author><author><name sortKey="Yoshimatsu, H" uniqKey="Yoshimatsu H">H Yoshimatsu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamamoto, T" uniqKey="Yamamoto T">T Yamamoto</name></author><author><name sortKey="Yamamoto, N" uniqKey="Yamamoto N">N Yamamoto</name></author><author><name sortKey="Doi, K" uniqKey="Doi K">K Doi</name></author><author><name sortKey="Oshima, A" uniqKey="Oshima A">A Oshima</name></author><author><name sortKey="Yoshimatsu, H" uniqKey="Yoshimatsu H">H Yoshimatsu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamamoto, T" uniqKey="Yamamoto T">T Yamamoto</name></author><author><name sortKey="Matsuda, N" uniqKey="Matsuda N">N Matsuda</name></author><author><name sortKey="Doi, K" uniqKey="Doi K">K Doi</name></author><author><name sortKey="Oshima, A" uniqKey="Oshima A">A Oshima</name></author><author><name sortKey="Yoshimatsu, H" uniqKey="Yoshimatsu H">H Yoshimatsu</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Yamamoto, T" uniqKey="Yamamoto T">T Yamamoto</name></author><author><name sortKey="Matsuda, N" uniqKey="Matsuda N">N Matsuda</name></author><author><name sortKey="Todokoro, T" uniqKey="Todokoro T">T Todokoro</name></author><author><name sortKey="Yoshimatsu, H" uniqKey="Yoshimatsu H">H Yoshimatsu</name></author><author><name sortKey="Narushima, M" uniqKey="Narushima M">M Narushima</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Japon</li></country><region><li>Région de Kantō</li></region><settlement><li>Tokyo</li></settlement><orgName><li>Université de Tokyo</li></orgName></list><tree><noCountry><name sortKey="Iida, Takuya" sort="Iida, Takuya" uniqKey="Iida T" first="Takuya" last="Iida">Takuya Iida</name><name sortKey="Koshima, Isao" sort="Koshima, Isao" uniqKey="Koshima I" first="Isao" last="Koshima">Isao Koshima</name><name sortKey="Narushima, Mitsunaga" sort="Narushima, Mitsunaga" uniqKey="Narushima M" first="Mitsunaga" last="Narushima">Mitsunaga Narushima</name><name sortKey="Yamamoto, Nana" sort="Yamamoto, Nana" uniqKey="Yamamoto N" first="Nana" last="Yamamoto">Nana Yamamoto</name><name sortKey="Yoshimatsu, Hidehiko" sort="Yoshimatsu, Hidehiko" uniqKey="Yoshimatsu H" first="Hidehiko" last="Yoshimatsu">Hidehiko Yoshimatsu</name></noCountry><country name="Japon"><region name="Région de Kantō"><name sortKey="Yamamoto, Takumi" sort="Yamamoto, Takumi" uniqKey="Yamamoto T" first="Takumi" last="Yamamoto">Takumi Yamamoto (chirurgien)</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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