[The microsurgical lymph vessel transplantation].
Identifieur interne : 008D31 ( Main/Exploration ); précédent : 008D30; suivant : 008D32[The microsurgical lymph vessel transplantation].
Auteurs : R G H. Baumeister [Allemagne] ; A. FrickSource :
- Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V... [ 0722-1819 ] ; 2003.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Animaux, Bras (), Enfant, Facteurs temps, Femelle, Humains, Jambe (), Lymphadénectomie, Lymphoedème (), Maladies de l'appareil génital mâle (), Maladies du pénis (), Microchirurgie, Mâle, Rats, Scrotum (), Sujet âgé, Vaisseaux lymphatiques (), Vaisseaux lymphatiques (transplantation), Études de suivi.
- MESH :
English descriptors
- KwdEn :
- Adult, Aged, Animals, Arm (surgery), Child, Female, Follow-Up Studies, Genital Diseases, Male (surgery), Humans, Leg (surgery), Lymph Node Excision, Lymphatic Vessels (surgery), Lymphatic Vessels (transplantation), Lymphedema (surgery), Male, Microsurgery, Middle Aged, Penile Diseases (surgery), Rats, Scrotum (surgery), Time Factors.
- MESH :
- surgery : Arm, Genital Diseases, Male, Leg, Lymphatic Vessels, Lymphedema, Penile Diseases, Scrotum.
- transplantation : Lymphatic Vessels.
- Adult, Aged, Animals, Child, Female, Follow-Up Studies, Humans, Lymph Node Excision, Male, Microsurgery, Middle Aged, Rats, Time Factors.
Abstract
Using advanced microsurgical techniques, single lymph vessels can be safely anastomosed and segments of lymphatics can bridge localized lymphatic blockades which are mostly due to lymphadenectomies. Lymphatic grafts are harvested from the patient's thigh with a length up to about 30 cm. In the case of an axillary blockade they are anastomosed with ascending lymph vessels at the upper arm and lymph vessels at the supraclavicular region. Unilateral oedemas of lower extremities are treated by transferring the grafts via the symphysis and anastomosing them with ascending lymphatics at the affected side. Lymphoedemas of the penis and the scrotum as well as lymphoedemas due to a localized peripheral lymphatic blockade can be treated by lymphatic grafts. In 127 arm oedemas the original difference in volume between the affected and the healthy arm was reduced at two third from 3368 cm (3) to 2567 cm(3) (p < 0.001). After a follow-up period of 2.6 years the volume was reduced to 2625 cm(3) (p < 0.001). The group of patients with a follow-up of at least ten years showed a volume of 2273 cm(3) (p < 0.001). The volume of unilateral lower extremity-lymphoedemas was reduced from 13 098 cm(3) to 10 578 cm(3) (p < 0.001) and showed a volume of 11 074 cm(3) after 1.7 years (p < 0.001) and 10 692 cm(3) after four years (p < 0.001). The original mean volume of the healthy contralateral leg was 9371 cm(3). Bridging localized gaps in the lymphatic system by autologous lymphatic grafts showed long lasting stable results. Starting the treatment of lymphoedemas by conservative procedures, one should not wait too long to ascertain the possibility of a microsurgical reconstruction in order to avoid increasing secondary tissue changes.
DOI: 10.1055/s-2003-42131
PubMed: 12968216
Affiliations:
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Baumeister</name><affiliation wicri:level="4"><nlm:affiliation>Plastische, Hand-, Mikrochirurgie, Chirurgische Klinik und Poliklinik - Grosshadern, Klinikum der Universität München, Germany. rbaumeis@gch.med.uni-muenchen.de</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Plastische, Hand-, Mikrochirurgie, Chirurgische Klinik und Poliklinik - Grosshadern, Klinikum der Universität München</wicri:regionArea><placeName><settlement type="city">Munich</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region></placeName><orgName type="university">Université Louis-et-Maximilien de Munich</orgName></affiliation></author><author><name sortKey="Frick, A" sort="Frick, A" uniqKey="Frick A" first="A" last="Frick">A. 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Baumeister</name><affiliation wicri:level="4"><nlm:affiliation>Plastische, Hand-, Mikrochirurgie, Chirurgische Klinik und Poliklinik - Grosshadern, Klinikum der Universität München, Germany. rbaumeis@gch.med.uni-muenchen.de</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Plastische, Hand-, Mikrochirurgie, Chirurgische Klinik und Poliklinik - Grosshadern, Klinikum der Universität München</wicri:regionArea><placeName><settlement type="city">Munich</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region></placeName><orgName type="university">Université Louis-et-Maximilien de Munich</orgName></affiliation></author><author><name sortKey="Frick, A" sort="Frick, A" uniqKey="Frick A" first="A" last="Frick">A. Frick</name></author></analytic><series><title level="j">Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...</title><idno type="ISSN">0722-1819</idno><imprint><date when="2003" type="published">2003</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Animals</term><term>Arm (surgery)</term><term>Child</term><term>Female</term><term>Follow-Up Studies</term><term>Genital Diseases, Male (surgery)</term><term>Humans</term><term>Leg (surgery)</term><term>Lymph Node Excision</term><term>Lymphatic Vessels (surgery)</term><term>Lymphatic Vessels (transplantation)</term><term>Lymphedema (surgery)</term><term>Male</term><term>Microsurgery</term><term>Middle Aged</term><term>Penile Diseases (surgery)</term><term>Rats</term><term>Scrotum (surgery)</term><term>Time Factors</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Animaux</term><term>Bras ()</term><term>Enfant</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Jambe ()</term><term>Lymphadénectomie</term><term>Lymphoedème ()</term><term>Maladies de l'appareil génital mâle ()</term><term>Maladies du pénis ()</term><term>Microchirurgie</term><term>Mâle</term><term>Rats</term><term>Scrotum ()</term><term>Sujet âgé</term><term>Vaisseaux lymphatiques ()</term><term>Vaisseaux lymphatiques (transplantation)</term><term>Études de suivi</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Arm</term><term>Genital Diseases, Male</term><term>Leg</term><term>Lymphatic Vessels</term><term>Lymphedema</term><term>Penile Diseases</term><term>Scrotum</term></keywords><keywords scheme="MESH" qualifier="transplantation" xml:lang="en"><term>Lymphatic Vessels</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Animals</term><term>Child</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymph Node Excision</term><term>Male</term><term>Microsurgery</term><term>Middle Aged</term><term>Rats</term><term>Time Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Animaux</term><term>Bras</term><term>Enfant</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Jambe</term><term>Lymphadénectomie</term><term>Lymphoedème</term><term>Maladies de l'appareil génital mâle</term><term>Maladies du pénis</term><term>Microchirurgie</term><term>Mâle</term><term>Rats</term><term>Scrotum</term><term>Sujet âgé</term><term>Vaisseaux lymphatiques</term><term>Études de suivi</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Using advanced microsurgical techniques, single lymph vessels can be safely anastomosed and segments of lymphatics can bridge localized lymphatic blockades which are mostly due to lymphadenectomies. Lymphatic grafts are harvested from the patient's thigh with a length up to about 30 cm. In the case of an axillary blockade they are anastomosed with ascending lymph vessels at the upper arm and lymph vessels at the supraclavicular region. Unilateral oedemas of lower extremities are treated by transferring the grafts via the symphysis and anastomosing them with ascending lymphatics at the affected side. Lymphoedemas of the penis and the scrotum as well as lymphoedemas due to a localized peripheral lymphatic blockade can be treated by lymphatic grafts. In 127 arm oedemas the original difference in volume between the affected and the healthy arm was reduced at two third from 3368 cm (3) to 2567 cm(3) (p < 0.001). After a follow-up period of 2.6 years the volume was reduced to 2625 cm(3) (p < 0.001). The group of patients with a follow-up of at least ten years showed a volume of 2273 cm(3) (p < 0.001). The volume of unilateral lower extremity-lymphoedemas was reduced from 13 098 cm(3) to 10 578 cm(3) (p < 0.001) and showed a volume of 11 074 cm(3) after 1.7 years (p < 0.001) and 10 692 cm(3) after four years (p < 0.001). The original mean volume of the healthy contralateral leg was 9371 cm(3). Bridging localized gaps in the lymphatic system by autologous lymphatic grafts showed long lasting stable results. Starting the treatment of lymphoedemas by conservative procedures, one should not wait too long to ascertain the possibility of a microsurgical reconstruction in order to avoid increasing secondary tissue changes.</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Bavière</li><li>District de Haute-Bavière</li></region><settlement><li>Munich</li></settlement><orgName><li>Université Louis-et-Maximilien de Munich</li></orgName></list><tree><noCountry><name sortKey="Frick, A" sort="Frick, A" uniqKey="Frick A" first="A" last="Frick">A. Frick</name></noCountry><country name="Allemagne"><region name="Bavière"><name sortKey="Baumeister, R G H" sort="Baumeister, R G H" uniqKey="Baumeister R" first="R G H" last="Baumeister">R G H. Baumeister</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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