Minimally invasive lymphatic supermicrosurgery (MILS): indocyanine green lymphography-guided simultaneous multisite lymphaticovenular anastomoses via millimeter skin incisions.
Identifieur interne : 001400 ( PubMed/Checkpoint ); précédent : 001399; suivant : 001401Minimally invasive lymphatic supermicrosurgery (MILS): indocyanine green lymphography-guided simultaneous multisite lymphaticovenular anastomoses via millimeter skin incisions.
Auteurs : Takumi Yamamoto (chirurgien) [Japon] ; Mitsunaga Narushima ; Hidehiko Yoshimatsu ; Yukio Seki ; Nana Yamamoto ; Aiko Oka ; Hisako Hara ; Isao KoshimaSource :
- Annals of plastic surgery [ 1536-3708 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Agents colorants, Anastomose chirurgicale, Bras, Durée opératoire, Femelle, Humains, Jambe, Lymphoedème (), Lymphographie, Microchirurgie (), Mâle, Phlébographie, Radiographie interventionnelle (), Résultat thérapeutique, Sujet âgé, Vaisseaux lymphatiques (), Vaisseaux lymphatiques (imagerie diagnostique), Veinules (), Veinules (imagerie diagnostique), Vert indocyanine.
- MESH :
- imagerie diagnostique : Vaisseaux lymphatiques, Veinules.
- Adulte d'âge moyen, Agents colorants, Anastomose chirurgicale, Bras, Durée opératoire, Femelle, Humains, Jambe, Lymphoedème, Lymphographie, Microchirurgie, Mâle, Phlébographie, Radiographie interventionnelle, Résultat thérapeutique, Sujet âgé, Vaisseaux lymphatiques, Veinules, Vert indocyanine.
English descriptors
- KwdEn :
- Aged, Anastomosis, Surgical, Arm, Coloring Agents, Female, Humans, Indocyanine Green, Leg, Lymphatic Vessels (diagnostic imaging), Lymphatic Vessels (surgery), Lymphedema (surgery), Lymphography, Male, Microsurgery (methods), Middle Aged, Operative Time, Phlebography, Radiography, Interventional (methods), Treatment Outcome, Venules (diagnostic imaging), Venules (surgery).
- MESH :
- chemical : Coloring Agents, Indocyanine Green.
- diagnostic imaging : Lymphatic Vessels, Venules.
- methods : Microsurgery, Radiography, Interventional.
- surgery : Lymphatic Vessels, Lymphedema, Venules.
- Aged, Anastomosis, Surgical, Arm, Female, Humans, Leg, Lymphography, Male, Middle Aged, Operative Time, Phlebography, Treatment Outcome.
Abstract
Among various surgical treatments, lymphaticovenular anastomosis (LVA), which bypasses congested lymph into venous circulation, is the least invasive surgical treatment. However, it usually entails skin incisions of around 3 cm, and operation time of around 4 hours. With multiple supermicrosurgeons under guidance of indocyanine green lymphography, LVAs can be simultaneously performed under local anesthesia within approximately 2 hours via small skin incisions with length less than 1 cm, allowing minimally invasive lymphatic supermicrosurgery (MILS). We performed MILS on 11 limbs of compression-refractory peripheral lymphedema cases. Length of skin incision for LVA ranged from 1 to 9 mm. Average operation time was 1.82 hours. Of the 11 limbs, 10 showed postoperative volume reduction. Indocyanine green lymphography clearly visualizes superficial lymph flows, which helps us to decide precise skin incision sites and find lymphatic vessels in LVA surgery, shortening skin incision length and operation time. Minimally invasive lymphatic supermicrosurgery can serve as the most reasonable treatment of compression-refractory peripheral lymphedema.
DOI: 10.1097/SAP.0b013e3182605580
PubMed: 23241778
Affiliations:
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pubmed:23241778Le document en format XML
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<term>Humans</term>
<term>Indocyanine Green</term>
<term>Leg</term>
<term>Lymphatic Vessels (diagnostic imaging)</term>
<term>Lymphatic Vessels (surgery)</term>
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<term>Male</term>
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<term>Bras</term>
<term>Durée opératoire</term>
<term>Femelle</term>
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<term>Veinules ()</term>
<term>Veinules (imagerie diagnostique)</term>
<term>Vert indocyanine</term>
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<term>Indocyanine Green</term>
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<front><div type="abstract" xml:lang="en">Among various surgical treatments, lymphaticovenular anastomosis (LVA), which bypasses congested lymph into venous circulation, is the least invasive surgical treatment. However, it usually entails skin incisions of around 3 cm, and operation time of around 4 hours. With multiple supermicrosurgeons under guidance of indocyanine green lymphography, LVAs can be simultaneously performed under local anesthesia within approximately 2 hours via small skin incisions with length less than 1 cm, allowing minimally invasive lymphatic supermicrosurgery (MILS). We performed MILS on 11 limbs of compression-refractory peripheral lymphedema cases. Length of skin incision for LVA ranged from 1 to 9 mm. Average operation time was 1.82 hours. Of the 11 limbs, 10 showed postoperative volume reduction. Indocyanine green lymphography clearly visualizes superficial lymph flows, which helps us to decide precise skin incision sites and find lymphatic vessels in LVA surgery, shortening skin incision length and operation time. Minimally invasive lymphatic supermicrosurgery can serve as the most reasonable treatment of compression-refractory peripheral lymphedema.</div>
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