Assessment and follow-up of patency after lymphovenous microsurgery for treatment of secondary lymphedema in external male genital organs.
Identifieur interne : 005080 ( Main/Exploration ); précédent : 005079; suivant : 005081Assessment and follow-up of patency after lymphovenous microsurgery for treatment of secondary lymphedema in external male genital organs.
Auteurs : Sylvain M. Mukenge [Italie] ; Marco Catena ; Daniela Negrini ; Francesca Ratti ; Andrea Moriondo ; Alberto Briganti ; Patrizio Rigatti ; Federica Cipriani ; Gianfranco FerlaSource :
- European urology [ 1873-7560 ] ; 2011.
Descripteurs français
- KwdFr :
- Anastomose chirurgicale, Colorants fluorescents, Facteurs temps, Humains, Italie, Lymphoedème (), Lymphoedème (imagerie diagnostique), Lymphoedème (étiologie), Lymphographie, Microchirurgie, Mâle, Résultat thérapeutique, Scrotum (), Scrotum (imagerie diagnostique), Sujet âgé, Vaisseaux lymphatiques (), Vaisseaux lymphatiques (imagerie diagnostique), Veines (), Vert indocyanine.
- MESH :
- imagerie diagnostique : Lymphoedème, Scrotum, Vaisseaux lymphatiques.
- étiologie : Lymphoedème.
- Anastomose chirurgicale, Colorants fluorescents, Facteurs temps, Humains, Italie, Lymphoedème, Lymphographie, Microchirurgie, Mâle, Résultat thérapeutique, Scrotum, Sujet âgé, Vaisseaux lymphatiques, Veines, Vert indocyanine.
English descriptors
- KwdEn :
- Aged, Anastomosis, Surgical, Fluorescent Dyes, Humans, Indocyanine Green, Italy, Lymphatic Vessels (diagnostic imaging), Lymphatic Vessels (surgery), Lymphedema (diagnostic imaging), Lymphedema (etiology), Lymphedema (surgery), Lymphography, Male, Microsurgery, Scrotum (blood supply), Scrotum (diagnostic imaging), Scrotum (surgery), Time Factors, Treatment Outcome, Veins (surgery).
- MESH :
- chemical : Fluorescent Dyes, Indocyanine Green.
- blood supply : Scrotum.
- diagnostic imaging : Lymphatic Vessels, Lymphedema, Scrotum.
- etiology : Lymphedema.
- surgery : Lymphatic Vessels, Lymphedema, Scrotum, Veins.
- Aged, Anastomosis, Surgical, Humans, Italy, Lymphography, Male, Microsurgery, Time Factors, Treatment Outcome.
Abstract
Secondary lymphedema of external male genital organs is a frequent complication of pelvic radical surgery following pelvic lymphadenectomy. Microsurgical lymphovenous anastomoses are usually performed using only the superficial scrotal lymphatics, excluding testicular lymphatic drainage. We have experimented using a new microsurgical technique based on lymphovenous anastomosis between the collectors of the spermatic funiculus and the veins of the pampiniform plexus, allowing testicular lymphatic drainage. The study included 11 patients with external genital organ lymphedema, five of whom were subjected to microsurgical lymphovenous derivation. At 3, 6, and 12 mo after surgery, the patency of lymphovenous anastomoses was assessed by noninvasive lymphography using indocyanine green fluorescence images obtained with the Photodynamic Eye (PDE) infrared camera system (Hamamatsu Photonics K.K., Hamamatsu, Japan). Progressive improvement of clinical conditions was assessed both by patients' self evaluation and by objective clinical follow-up based on: (1) PDE lymphography, (2) tomography of the pubic area, (3) recovery of the soft consistency of the scrotal tissue, (4) recovery of the scrotal skin normochromic aspect, (5) absence of pain, and (6) disappearance of edema with evident reduction of the scrotal and penile dimensions and normal palpability of the testis. The present study shows that lymphovenous anastomosis is a valuable method of resolving the edematous condition. The indocyanine green approach for lymphangiography is a very supportive method during follow-up because, with the least invasive approach, it is possible to ascertain the complete patency of the anastomosis, to confirm its localization, and to assess its lymphatic drainage.
DOI: 10.1016/j.eururo.2010.11.020
PubMed: 21129845
Affiliations:
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Mukenge</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Sciences, Università Vita e Salute, San Raffaele, Milano, Italy. mukenge.mvunde@hsr.it</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Surgical Sciences, Università Vita e Salute, San Raffaele, Milano</wicri:regionArea><wicri:noRegion>Milano</wicri:noRegion></affiliation></author><author><name sortKey="Catena, Marco" sort="Catena, Marco" uniqKey="Catena M" first="Marco" last="Catena">Marco Catena</name></author><author><name sortKey="Negrini, Daniela" sort="Negrini, Daniela" uniqKey="Negrini D" first="Daniela" last="Negrini">Daniela Negrini</name></author><author><name sortKey="Ratti, Francesca" sort="Ratti, Francesca" uniqKey="Ratti F" first="Francesca" last="Ratti">Francesca Ratti</name></author><author><name sortKey="Moriondo, Andrea" sort="Moriondo, Andrea" uniqKey="Moriondo A" first="Andrea" last="Moriondo">Andrea Moriondo</name></author><author><name sortKey="Briganti, Alberto" sort="Briganti, Alberto" uniqKey="Briganti A" first="Alberto" last="Briganti">Alberto Briganti</name></author><author><name sortKey="Rigatti, Patrizio" sort="Rigatti, Patrizio" uniqKey="Rigatti P" first="Patrizio" last="Rigatti">Patrizio Rigatti</name></author><author><name sortKey="Cipriani, Federica" sort="Cipriani, Federica" uniqKey="Cipriani F" first="Federica" last="Cipriani">Federica Cipriani</name></author><author><name sortKey="Ferla, Gianfranco" sort="Ferla, Gianfranco" uniqKey="Ferla G" first="Gianfranco" last="Ferla">Gianfranco Ferla</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2011">2011</date><idno type="RBID">pubmed:21129845</idno><idno type="pmid">21129845</idno><idno type="doi">10.1016/j.eururo.2010.11.020</idno><idno type="wicri:Area/PubMed/Corpus">002824</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002824</idno><idno type="wicri:Area/PubMed/Curation">002824</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">002824</idno><idno type="wicri:Area/PubMed/Checkpoint">002824</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">002824</idno><idno type="wicri:Area/Ncbi/Merge">003F95</idno><idno type="wicri:Area/Ncbi/Curation">003F95</idno><idno type="wicri:Area/Ncbi/Checkpoint">003F95</idno><idno type="wicri:Area/Main/Merge">005119</idno><idno type="wicri:Area/Main/Curation">005080</idno><idno type="wicri:Area/Main/Exploration">005080</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Assessment and follow-up of patency after lymphovenous microsurgery for treatment of secondary lymphedema in external male genital organs.</title><author><name sortKey="Mukenge, Sylvain M" sort="Mukenge, Sylvain M" uniqKey="Mukenge S" first="Sylvain M" last="Mukenge">Sylvain M. 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Microsurgical lymphovenous anastomoses are usually performed using only the superficial scrotal lymphatics, excluding testicular lymphatic drainage. We have experimented using a new microsurgical technique based on lymphovenous anastomosis between the collectors of the spermatic funiculus and the veins of the pampiniform plexus, allowing testicular lymphatic drainage. The study included 11 patients with external genital organ lymphedema, five of whom were subjected to microsurgical lymphovenous derivation. At 3, 6, and 12 mo after surgery, the patency of lymphovenous anastomoses was assessed by noninvasive lymphography using indocyanine green fluorescence images obtained with the Photodynamic Eye (PDE) infrared camera system (Hamamatsu Photonics K.K., Hamamatsu, Japan). Progressive improvement of clinical conditions was assessed both by patients' self evaluation and by objective clinical follow-up based on: (1) PDE lymphography, (2) tomography of the pubic area, (3) recovery of the soft consistency of the scrotal tissue, (4) recovery of the scrotal skin normochromic aspect, (5) absence of pain, and (6) disappearance of edema with evident reduction of the scrotal and penile dimensions and normal palpability of the testis. The present study shows that lymphovenous anastomosis is a valuable method of resolving the edematous condition. The indocyanine green approach for lymphangiography is a very supportive method during follow-up because, with the least invasive approach, it is possible to ascertain the complete patency of the anastomosis, to confirm its localization, and to assess its lymphatic drainage.</div></front></TEI><affiliations><list><country><li>Italie</li></country></list><tree><noCountry><name sortKey="Briganti, Alberto" sort="Briganti, Alberto" uniqKey="Briganti A" first="Alberto" last="Briganti">Alberto Briganti</name><name sortKey="Catena, Marco" sort="Catena, Marco" uniqKey="Catena M" first="Marco" last="Catena">Marco Catena</name><name sortKey="Cipriani, Federica" sort="Cipriani, Federica" uniqKey="Cipriani F" first="Federica" last="Cipriani">Federica Cipriani</name><name sortKey="Ferla, Gianfranco" sort="Ferla, Gianfranco" uniqKey="Ferla G" first="Gianfranco" last="Ferla">Gianfranco Ferla</name><name sortKey="Moriondo, Andrea" sort="Moriondo, Andrea" uniqKey="Moriondo A" first="Andrea" last="Moriondo">Andrea Moriondo</name><name sortKey="Negrini, Daniela" sort="Negrini, Daniela" uniqKey="Negrini D" first="Daniela" last="Negrini">Daniela Negrini</name><name sortKey="Ratti, Francesca" sort="Ratti, Francesca" uniqKey="Ratti F" first="Francesca" last="Ratti">Francesca Ratti</name><name sortKey="Rigatti, Patrizio" sort="Rigatti, Patrizio" uniqKey="Rigatti P" first="Patrizio" last="Rigatti">Patrizio Rigatti</name></noCountry><country name="Italie"><noRegion><name sortKey="Mukenge, Sylvain M" sort="Mukenge, Sylvain M" uniqKey="Mukenge S" first="Sylvain M" last="Mukenge">Sylvain M. 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