Outcomes of lymphaticovenous side-to-end anastomosis in peripheral lymphedema
Identifieur interne : 000851 ( PascalFrancis/Curation ); précédent : 000850; suivant : 000852Outcomes of lymphaticovenous side-to-end anastomosis in peripheral lymphedema
Auteurs : Jiro Maegawa [Japon] ; Yuichiro Yabuki [Japon] ; Hiroto Tomoeda [Japon] ; Misato Hosono [Japon] ; Kazunori Yasumura [Japon]Source :
- Journal of vascular surgery [ 0741-5214 ] ; 2012.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Chirurgie.
English descriptors
- KwdEn :
Abstract
Objective: Lymphaticovenous anastomosis has been used for patients with peripheral lymphedema. However, the efficacy of this procedure is controversial due to a lack of evidence regarding postoperative patency. We sought to determine midterm postoperative patency of lymphaticovenous side-to-end anastomoses (LVSEAs) using indocyanine green fluorescence lymphography. Methods: This was a retrospective observational study set in a teaching hospital. Of 107 patients with chronic lymphedema who underwent 472 LVSEAs, 57 (223 anastomoses) consented to fluorescence lymphography and comprised the study cohort. The intervention consisted of a microsurgical LVSEA performed with a suture-stent method. Patients also had preoperative and postoperative complex decongestive physiotherapy. Anastomosis patency was assessed using indocyanine green fluorescence lymphography ≥6 months after surgery. Patency rates were calculated using Kaplan-Meier analysis. We assessed volume reduction on the operated-on limb and compared this between patients in whom anastomoses were patent and those in whom anastomoses were not obviously patent. Results: Patency could be evaluated only at the dorsum of the foot, ankle, and lower leg because the near-infrared rays emitted by the special camera used could not penetrate the deep subcutaneous layer containing collective lymphatics in areas such as the thigh. Several patterns were observed on fluorescence lymphography: straight, radial, and L-shaped. Cumulative patency rates of LVSEAs were 75% at 12 months and 36% at 24 months after surgery. No significant difference in volume change of the affected limb was seen between the 34 patients with patent anastomosis (600 ± 969 mL) and the 24 patients without obvious evidence of patency (420 ± 874 mL). Conclusions: Although further study is required to determine factors leading to anastomotic obstruction and to optimize the results of microlymphatic surgery, the present LVSEA technique appears promising.
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aut.</sZ></inist:fA14><country>Japon</country></affiliation></author><author><name sortKey="Tomoeda, Hiroto" sort="Tomoeda, Hiroto" uniqKey="Tomoeda H" first="Hiroto" last="Tomoeda">Hiroto Tomoeda</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital</s1><s3>JPN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Japon</country></affiliation></author><author><name sortKey="Hosono, Misato" sort="Hosono, Misato" uniqKey="Hosono M" first="Misato" last="Hosono">Misato Hosono</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital</s1><s3>JPN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Japon</country></affiliation></author><author><name sortKey="Yasumura, Kazunori" sort="Yasumura, Kazunori" uniqKey="Yasumura K" first="Kazunori" last="Yasumura">Kazunori Yasumura</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital</s1><s3>JPN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Japon</country></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">12-0138309</idno><date when="2012">2012</date><idno type="stanalyst">PASCAL 12-0138309 INIST</idno><idno type="RBID">Pascal:12-0138309</idno><idno type="wicri:Area/PascalFrancis/Corpus">000106</idno><idno type="wicri:Area/PascalFrancis/Curation">000851</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Outcomes of lymphaticovenous side-to-end anastomosis in peripheral lymphedema</title><author><name sortKey="Maegawa, Jiro" sort="Maegawa, Jiro" uniqKey="Maegawa J" first="Jiro" last="Maegawa">Jiro Maegawa</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital</s1><s3>JPN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Japon</country></affiliation></author><author><name sortKey="Yabuki, Yuichiro" sort="Yabuki, Yuichiro" uniqKey="Yabuki Y" first="Yuichiro" last="Yabuki">Yuichiro Yabuki</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital</s1><s3>JPN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Japon</country></affiliation></author><author><name sortKey="Tomoeda, Hiroto" sort="Tomoeda, Hiroto" uniqKey="Tomoeda H" first="Hiroto" last="Tomoeda">Hiroto Tomoeda</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital</s1><s3>JPN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Japon</country></affiliation></author><author><name sortKey="Hosono, Misato" sort="Hosono, Misato" uniqKey="Hosono M" first="Misato" last="Hosono">Misato Hosono</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital</s1><s3>JPN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Japon</country></affiliation></author><author><name sortKey="Yasumura, Kazunori" sort="Yasumura, Kazunori" uniqKey="Yasumura K" first="Kazunori" last="Yasumura">Kazunori Yasumura</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital</s1><s3>JPN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Japon</country></affiliation></author></analytic><series><title level="j" type="main">Journal of vascular surgery</title><title level="j" type="abbreviated">J. vasc. surg.</title><idno type="ISSN">0741-5214</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of vascular surgery</title><title level="j" type="abbreviated">J. vasc. surg.</title><idno type="ISSN">0741-5214</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anastomosis</term><term>Cardiovascular disease</term><term>Lymphedema</term><term>Prognosis</term><term>Surgery</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Lymphoedème</term><term>Pathologie de l'appareil circulatoire</term><term>Pronostic</term><term>Anastomose</term><term>Chirurgie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: Lymphaticovenous anastomosis has been used for patients with peripheral lymphedema. However, the efficacy of this procedure is controversial due to a lack of evidence regarding postoperative patency. We sought to determine<sub> </sub> midterm postoperative patency of lymphaticovenous side-to-end anastomoses (LVSEAs) using indocyanine green fluorescence lymphography. Methods: This was a retrospective observational study set in a teaching hospital. Of 107 patients with chronic lymphedema who underwent 472 LVSEAs, 57 (223 anastomoses) consented to fluorescence lymphography and comprised the study cohort. The intervention consisted of a microsurgical LVSEA performed with a suture-stent method. Patients also had preoperative and postoperative complex decongestive physiotherapy. Anastomosis patency was assessed using indocyanine green fluorescence lymphography ≥6 months after surgery. Patency rates were calculated using Kaplan-Meier analysis. We assessed volume reduction on the operated-on limb and compared this between patients in whom anastomoses were patent and those in whom anastomoses were not obviously patent. Results: Patency could be evaluated only at the dorsum of the foot, ankle, and lower leg because the near-infrared rays emitted by the special camera used could not penetrate the deep subcutaneous layer containing collective lymphatics in areas such as the thigh. Several patterns were observed on fluorescence lymphography: straight, radial, and L-shaped. Cumulative patency rates of LVSEAs were 75% at 12 months and 36% at 24 months after surgery. No significant difference in volume change of the affected limb was seen between the 34 patients with patent anastomosis (600 ± 969 mL) and the 24 patients without obvious evidence of patency (420 ± 874 mL). Conclusions: Although further study is required to determine factors leading to anastomotic obstruction and to optimize the results of microlymphatic surgery, the present LVSEA technique appears promising.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0741-5214</s0></fA01><fA02 i1="01"><s0>JVSUES</s0></fA02><fA03 i2="1"><s0>J. vasc. surg.</s0></fA03><fA05><s2>55</s2></fA05><fA06><s2>3</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Outcomes of lymphaticovenous side-to-end anastomosis in peripheral lymphedema</s1></fA08><fA11 i1="01" i2="1"><s1>MAEGAWA (Jiro)</s1></fA11><fA11 i1="02" i2="1"><s1>YABUKI (Yuichiro)</s1></fA11><fA11 i1="03" i2="1"><s1>TOMOEDA (Hiroto)</s1></fA11><fA11 i1="04" i2="1"><s1>HOSONO (Misato)</s1></fA11><fA11 i1="05" i2="1"><s1>YASUMURA (Kazunori)</s1></fA11><fA14 i1="01"><s1>Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital</s1><s3>JPN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></fA14><fA20><s1>753-760</s1></fA20><fA21><s1>2012</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20352</s2><s5>354000509722990170</s5></fA43><fA44><s0>0000</s0><s1>© 2012 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>21 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>12-0138309</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Journal of vascular surgery</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Objective: Lymphaticovenous anastomosis has been used for patients with peripheral lymphedema. However, the efficacy of this procedure is controversial due to a lack of evidence regarding postoperative patency. We sought to determine<sub> </sub> midterm postoperative patency of lymphaticovenous side-to-end anastomoses (LVSEAs) using indocyanine green fluorescence lymphography. Methods: This was a retrospective observational study set in a teaching hospital. Of 107 patients with chronic lymphedema who underwent 472 LVSEAs, 57 (223 anastomoses) consented to fluorescence lymphography and comprised the study cohort. The intervention consisted of a microsurgical LVSEA performed with a suture-stent method. Patients also had preoperative and postoperative complex decongestive physiotherapy. Anastomosis patency was assessed using indocyanine green fluorescence lymphography ≥6 months after surgery. Patency rates were calculated using Kaplan-Meier analysis. We assessed volume reduction on the operated-on limb and compared this between patients in whom anastomoses were patent and those in whom anastomoses were not obviously patent. Results: Patency could be evaluated only at the dorsum of the foot, ankle, and lower leg because the near-infrared rays emitted by the special camera used could not penetrate the deep subcutaneous layer containing collective lymphatics in areas such as the thigh. Several patterns were observed on fluorescence lymphography: straight, radial, and L-shaped. Cumulative patency rates of LVSEAs were 75% at 12 months and 36% at 24 months after surgery. No significant difference in volume change of the affected limb was seen between the 34 patients with patent anastomosis (600 ± 969 mL) and the 24 patients without obvious evidence of patency (420 ± 874 mL). Conclusions: Although further study is required to determine factors leading to anastomotic obstruction and to optimize the results of microlymphatic surgery, the present LVSEA technique appears promising.</s0></fC01><fC02 i1="01" i2="X"><s0>002B25F</s0></fC02><fC02 i1="02" i2="X"><s0>002B24F01</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Lymphoedème</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Lymphedema</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Linfedema</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Pathologie de l'appareil circulatoire</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Cardiovascular disease</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Pronostic</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Prognosis</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Pronóstico</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Anastomose</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Anastomosis</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Anastomosis</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Chirurgie</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Surgery</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Cirugía</s0><s5>11</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Pathologie des vaisseaux lymphatiques</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Lymphatic vessel disease</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Linfático patología</s0><s5>37</s5></fC07><fN21><s1>107</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist></record>Pour manipuler ce document sous Unix (Dilib)
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