Complete lymph flow reconstruction: A free vascularized lymph node true perforator flap transfer with efferent lymphaticolymphatic anastomosis.
Identifieur interne : 000691 ( PubMed/Corpus ); précédent : 000690; suivant : 000692Complete lymph flow reconstruction: A free vascularized lymph node true perforator flap transfer with efferent lymphaticolymphatic anastomosis.
Auteurs : Takumi Yamamoto ; Hidehiko Yoshimatsu ; Nana YamamotoSource :
- Journal of plastic, reconstructive & aesthetic surgery : JPRAS [ 1878-0539 ] ; 2016.
English descriptors
- KwdEn :
- Anastomosis, Surgical (methods), Female, Groin, Humans, Lower Extremity, Lymph Nodes (diagnostic imaging), Lymph Nodes (transplantation), Lymphatic Vessels (surgery), Lymphedema (diagnosis), Lymphedema (etiology), Lymphedema (surgery), Lymphography, Microsurgery (methods), Middle Aged, Perforator Flap (blood supply), Reconstructive Surgical Procedures (methods), Treatment Outcome.
- MESH :
- blood supply : Perforator Flap.
- diagnosis : Lymphedema.
- diagnostic imaging : Lymph Nodes.
- etiology : Lymphedema.
- methods : Anastomosis, Surgical, Microsurgery, Reconstructive Surgical Procedures.
- surgery : Lymphatic Vessels, Lymphedema.
- transplantation : Lymph Nodes.
- Female, Groin, Humans, Lower Extremity, Lymphography, Middle Aged, Treatment Outcome.
Abstract
Treatment of primary lower extremity lymphedema (LEL) is challenging, and lymph node transfer (LNT) can be a choice of treatment for progressive LEL. However, LNT has a risk of donor site lymphedema and possible lymph node (LN) sclerosis due to efferent lymphatic vessel (ELV) obstruction. Here, we report the first case of complete lymph flow reconstruction with true perforator LNT with efferent lymphaticolymphatic anastomosis (ELLA) for a patient with primary LEL and severe lymphosclerosis. A 49-year-old female suffered from primary progressive unilateral left LEL refractory to conservative treatments with frequent episodes of cellulitis. A true perforator LN flap was selectively harvested from the left lateral thoracic region under indocyanine green (ICG) lymphography navigation and transferred to the left groin with perforator-to-perforator anastomosis. The ELV of the transplanted LN was supermicrosurgically anastomosed to the contralateral iliac lymphatic vessel that was subcutaneously transferred to the left groin. Postoperatively, the patient experienced no episode of cellulitis with reduced degree of compression treatment, and lymphedematous volume decreased from 306 to 264 in terms of LEL index. Postoperative ICG lymphography showed evidence of reconstructed lymph flow from the left foot to the left groin and to the right inguinal LN through the transplanted LN flap and the ELLA. There were no subjective or objective findings of donor site lymphedema of the left arm or the right back and the lower extremity. True perforator LN flap with ELLA is a safe and effective treatment and has the potential to be a useful therapeutic option for primary unilateral LEL.
DOI: 10.1016/j.bjps.2016.06.028
PubMed: 27449876
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pubmed:27449876Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Complete lymph flow reconstruction: A free vascularized lymph node true perforator flap transfer with efferent lymphaticolymphatic anastomosis.</title><author><name sortKey="Yamamoto, Takumi" sort="Yamamoto, Takumi" uniqKey="Yamamoto T" first="Takumi" last="Yamamoto">Takumi Yamamoto</name><affiliation><nlm:affiliation>Department of Plastic Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan; Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan. Electronic address: tyamamoto-tky@umin.ac.jp.</nlm:affiliation></affiliation></author><author><name sortKey="Yoshimatsu, Hidehiko" sort="Yoshimatsu, Hidehiko" uniqKey="Yoshimatsu H" first="Hidehiko" last="Yoshimatsu">Hidehiko Yoshimatsu</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan.</nlm:affiliation></affiliation></author><author><name sortKey="Yamamoto, Nana" sort="Yamamoto, Nana" uniqKey="Yamamoto N" first="Nana" last="Yamamoto">Nana Yamamoto</name><affiliation><nlm:affiliation>Department of Plastic Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:27449876</idno><idno type="pmid">27449876</idno><idno type="doi">10.1016/j.bjps.2016.06.028</idno><idno type="wicri:Area/PubMed/Corpus">000691</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000691</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Complete lymph flow reconstruction: A free vascularized lymph node true perforator flap transfer with efferent lymphaticolymphatic anastomosis.</title><author><name sortKey="Yamamoto, Takumi" sort="Yamamoto, Takumi" uniqKey="Yamamoto T" first="Takumi" last="Yamamoto">Takumi Yamamoto</name><affiliation><nlm:affiliation>Department of Plastic Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan; Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan. Electronic address: tyamamoto-tky@umin.ac.jp.</nlm:affiliation></affiliation></author><author><name sortKey="Yoshimatsu, Hidehiko" sort="Yoshimatsu, Hidehiko" uniqKey="Yoshimatsu H" first="Hidehiko" last="Yoshimatsu">Hidehiko Yoshimatsu</name><affiliation><nlm:affiliation>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan.</nlm:affiliation></affiliation></author><author><name sortKey="Yamamoto, Nana" sort="Yamamoto, Nana" uniqKey="Yamamoto N" first="Nana" last="Yamamoto">Nana Yamamoto</name><affiliation><nlm:affiliation>Department of Plastic Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Journal of plastic, reconstructive & aesthetic surgery : JPRAS</title><idno type="eISSN">1878-0539</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anastomosis, Surgical (methods)</term><term>Female</term><term>Groin</term><term>Humans</term><term>Lower Extremity</term><term>Lymph Nodes (diagnostic imaging)</term><term>Lymph Nodes (transplantation)</term><term>Lymphatic Vessels (surgery)</term><term>Lymphedema (diagnosis)</term><term>Lymphedema (etiology)</term><term>Lymphedema (surgery)</term><term>Lymphography</term><term>Microsurgery (methods)</term><term>Middle Aged</term><term>Perforator Flap (blood supply)</term><term>Reconstructive Surgical Procedures (methods)</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" qualifier="blood supply" xml:lang="en"><term>Perforator Flap</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Lymph Nodes</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Anastomosis, Surgical</term><term>Microsurgery</term><term>Reconstructive Surgical Procedures</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Lymphatic Vessels</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="transplantation" xml:lang="en"><term>Lymph Nodes</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Female</term><term>Groin</term><term>Humans</term><term>Lower Extremity</term><term>Lymphography</term><term>Middle Aged</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Treatment of primary lower extremity lymphedema (LEL) is challenging, and lymph node transfer (LNT) can be a choice of treatment for progressive LEL. However, LNT has a risk of donor site lymphedema and possible lymph node (LN) sclerosis due to efferent lymphatic vessel (ELV) obstruction. Here, we report the first case of complete lymph flow reconstruction with true perforator LNT with efferent lymphaticolymphatic anastomosis (ELLA) for a patient with primary LEL and severe lymphosclerosis. A 49-year-old female suffered from primary progressive unilateral left LEL refractory to conservative treatments with frequent episodes of cellulitis. A true perforator LN flap was selectively harvested from the left lateral thoracic region under indocyanine green (ICG) lymphography navigation and transferred to the left groin with perforator-to-perforator anastomosis. The ELV of the transplanted LN was supermicrosurgically anastomosed to the contralateral iliac lymphatic vessel that was subcutaneously transferred to the left groin. Postoperatively, the patient experienced no episode of cellulitis with reduced degree of compression treatment, and lymphedematous volume decreased from 306 to 264 in terms of LEL index. Postoperative ICG lymphography showed evidence of reconstructed lymph flow from the left foot to the left groin and to the right inguinal LN through the transplanted LN flap and the ELLA. There were no subjective or objective findings of donor site lymphedema of the left arm or the right back and the lower extremity. True perforator LN flap with ELLA is a safe and effective treatment and has the potential to be a useful therapeutic option for primary unilateral LEL.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27449876</PMID><DateCreated><Year>2016</Year><Month>08</Month><Day>15</Day></DateCreated><DateCompleted><Year>2017</Year><Month>04</Month><Day>13</Day></DateCompleted><DateRevised><Year>2017</Year><Month>08</Month><Day>17</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1878-0539</ISSN><JournalIssue CitedMedium="Internet"><Volume>69</Volume><Issue>9</Issue><PubDate><Year>2016</Year><Month>Sep</Month></PubDate></JournalIssue><Title>Journal of plastic, reconstructive & aesthetic surgery : JPRAS</Title><ISOAbbreviation>J Plast Reconstr Aesthet Surg</ISOAbbreviation></Journal><ArticleTitle>Complete lymph flow reconstruction: A free vascularized lymph node true perforator flap transfer with efferent lymphaticolymphatic anastomosis.</ArticleTitle><Pagination><MedlinePgn>1227-33</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.bjps.2016.06.028</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S1748-6815(16)30144-9</ELocationID><Abstract><AbstractText>Treatment of primary lower extremity lymphedema (LEL) is challenging, and lymph node transfer (LNT) can be a choice of treatment for progressive LEL. However, LNT has a risk of donor site lymphedema and possible lymph node (LN) sclerosis due to efferent lymphatic vessel (ELV) obstruction. Here, we report the first case of complete lymph flow reconstruction with true perforator LNT with efferent lymphaticolymphatic anastomosis (ELLA) for a patient with primary LEL and severe lymphosclerosis. A 49-year-old female suffered from primary progressive unilateral left LEL refractory to conservative treatments with frequent episodes of cellulitis. A true perforator LN flap was selectively harvested from the left lateral thoracic region under indocyanine green (ICG) lymphography navigation and transferred to the left groin with perforator-to-perforator anastomosis. The ELV of the transplanted LN was supermicrosurgically anastomosed to the contralateral iliac lymphatic vessel that was subcutaneously transferred to the left groin. Postoperatively, the patient experienced no episode of cellulitis with reduced degree of compression treatment, and lymphedematous volume decreased from 306 to 264 in terms of LEL index. Postoperative ICG lymphography showed evidence of reconstructed lymph flow from the left foot to the left groin and to the right inguinal LN through the transplanted LN flap and the ELLA. There were no subjective or objective findings of donor site lymphedema of the left arm or the right back and the lower extremity. True perforator LN flap with ELLA is a safe and effective treatment and has the potential to be a useful therapeutic option for primary unilateral LEL.</AbstractText><CopyrightInformation>Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Yamamoto</LastName><ForeName>Takumi</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Plastic Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan; Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan. Electronic address: tyamamoto-tky@umin.ac.jp.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yoshimatsu</LastName><ForeName>Hidehiko</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yamamoto</LastName><ForeName>Nana</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Plastic Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>07</Month><Day>02</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>J Plast Reconstr Aesthet Surg</MedlineTA><NlmUniqueID>101264239</NlmUniqueID><ISSNLinking>1748-6815</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000714" MajorTopicYN="N">Anastomosis, Surgical</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006119" MajorTopicYN="N">Groin</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D035002" MajorTopicYN="N">Lower Extremity</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008198" MajorTopicYN="N">Lymph Nodes</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000637" MajorTopicYN="Y">transplantation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D042601" MajorTopicYN="N">Lymphatic Vessels</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008220" MajorTopicYN="N">Lymphography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008866" MajorTopicYN="N">Microsurgery</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D061525" MajorTopicYN="N">Perforator Flap</DescriptorName><QualifierName UI="Q000098" MajorTopicYN="Y">blood supply</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019651" MajorTopicYN="N">Reconstructive Surgical Procedures</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Indocyanine green</Keyword><Keyword MajorTopicYN="Y">Lymph & node</Keyword><Keyword MajorTopicYN="Y">Lymphaticolymphatic</Keyword><Keyword MajorTopicYN="Y">Lymphedema</Keyword><Keyword MajorTopicYN="Y">Perforator</Keyword><Keyword MajorTopicYN="Y">Supermicrosurgery</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>04</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2016</Year><Month>05</Month><Day>26</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2016</Year><Month>06</Month><Day>22</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>7</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>7</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>4</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27449876</ArticleId><ArticleId IdType="pii">S1748-6815(16)30144-9</ArticleId><ArticleId IdType="doi">10.1016/j.bjps.2016.06.028</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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