Lymphadiposal Flaps and Lymphaticovenular Anastomoses for Severe Leg Edema: Functional Reconstruction for Lymph Drainage System.
Identifieur interne : 000D21 ( PubMed/Curation ); précédent : 000D20; suivant : 000D22Lymphadiposal Flaps and Lymphaticovenular Anastomoses for Severe Leg Edema: Functional Reconstruction for Lymph Drainage System.
Auteurs : Isao Koshima [Japon] ; Mitsunaga Narushima [Japon] ; Makoto Mihara [Japon] ; Takumi Yamamoto [Japon] ; Hisako Hara [Japon] ; Azusa Ohshima [Japon] ; Kazuki Kikuchi [Japon] ; Ken Todokoro [Japon] ; Yukio Seki [Japon] ; Takuya Iida [Japon] ; Masahiro Nakagawa [Japon]Source :
- Journal of reconstructive microsurgery [ 1098-8947 ] ; 2016.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- methods : Microsurgery.
- surgery : Lower Extremity, Lymphedema.
- transplantation : Lymph Nodes.
- Adolescent, Adult, Aged, Anastomosis, Surgical, Humans, Middle Aged, Surgical Flaps.
Abstract
Collecting lymphatics have lymph-drainage function with contraction of smooth muscle cells. Patients with edema have lost this drainage function due to degeneration of smooth muscle cells. Lymphaticovenular (LV) anastomosis salvages smooth muscle cells from reversible degeneration (mild edema), but muscle cells cannot be recovered from irreversible degeneration (severe edema). Therefore, in severe edema, LV anastomoses cannot reestablish the drainage function of the lymphatic system.To overcome this weakness of LV bypass methods for severe edema, new methods were instituted for repair of this missing drainage function using a lymphadiposal flap from the contralateral foot for hemilateral edema, or transfer of lateral thoracic lymph nodes for bilateral edema.
DOI: 10.1055/s-0035-1554935
PubMed: 26258914
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first="Takuya" last="Iida">Takuya Iida</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo</wicri:regionArea></affiliation></author><author><name sortKey="Nakagawa, Masahiro" sort="Nakagawa, Masahiro" uniqKey="Nakagawa M" first="Masahiro" last="Nakagawa">Masahiro Nakagawa</name><affiliation wicri:level="1"><nlm:affiliation>Shizuoka Cancer Center, Tokyo and Shizuoka, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Shizuoka Cancer Center, Tokyo and Shizuoka</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:26258914</idno><idno 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School of Medicine, The University of Tokyo, Tokyo</wicri:regionArea></affiliation></author><author><name sortKey="Narushima, Mitsunaga" sort="Narushima, Mitsunaga" uniqKey="Narushima M" first="Mitsunaga" last="Narushima">Mitsunaga Narushima</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo</wicri:regionArea></affiliation></author><author><name sortKey="Mihara, Makoto" sort="Mihara, Makoto" uniqKey="Mihara M" first="Makoto" last="Mihara">Makoto Mihara</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo</wicri:regionArea></affiliation></author><author><name sortKey="Yamamoto, Takumi" sort="Yamamoto, Takumi" uniqKey="Yamamoto T" first="Takumi" last="Yamamoto">Takumi Yamamoto</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo</wicri:regionArea></affiliation></author><author><name sortKey="Hara, Hisako" sort="Hara, Hisako" uniqKey="Hara H" first="Hisako" last="Hara">Hisako Hara</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo</wicri:regionArea></affiliation></author><author><name sortKey="Ohshima, Azusa" sort="Ohshima, Azusa" uniqKey="Ohshima A" first="Azusa" last="Ohshima">Azusa Ohshima</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo</wicri:regionArea></affiliation></author><author><name sortKey="Kikuchi, Kazuki" sort="Kikuchi, Kazuki" uniqKey="Kikuchi K" first="Kazuki" last="Kikuchi">Kazuki Kikuchi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo</wicri:regionArea></affiliation></author><author><name sortKey="Todokoro, Ken" sort="Todokoro, Ken" uniqKey="Todokoro K" first="Ken" last="Todokoro">Ken Todokoro</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo</wicri:regionArea></affiliation></author><author><name sortKey="Seki, Yukio" sort="Seki, Yukio" uniqKey="Seki Y" first="Yukio" last="Seki">Yukio Seki</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo</wicri:regionArea></affiliation></author><author><name sortKey="Iida, Takuya" sort="Iida, Takuya" uniqKey="Iida T" first="Takuya" last="Iida">Takuya Iida</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo</wicri:regionArea></affiliation></author><author><name sortKey="Nakagawa, Masahiro" sort="Nakagawa, Masahiro" uniqKey="Nakagawa M" first="Masahiro" last="Nakagawa">Masahiro Nakagawa</name><affiliation wicri:level="1"><nlm:affiliation>Shizuoka Cancer Center, Tokyo and Shizuoka, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Shizuoka Cancer Center, Tokyo and Shizuoka</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of reconstructive microsurgery</title><idno type="eISSN">1098-8947</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Anastomosis, Surgical</term><term>Humans</term><term>Lower Extremity (surgery)</term><term>Lymph Nodes (transplantation)</term><term>Lymphedema (surgery)</term><term>Microsurgery (methods)</term><term>Middle Aged</term><term>Surgical Flaps</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Anastomose chirurgicale</term><term>Humains</term><term>Lambeaux chirurgicaux</term><term>Lymphoedème ()</term><term>Membre inférieur ()</term><term>Microchirurgie ()</term><term>Noeuds lymphatiques (transplantation)</term><term>Sujet âgé</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Microsurgery</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Lower Extremity</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>Adolescent</term><term>Adult</term><term>Aged</term><term>Anastomosis, Surgical</term><term>Humans</term><term>Middle Aged</term><term>Surgical Flaps</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Anastomose chirurgicale</term><term>Humains</term><term>Lambeaux chirurgicaux</term><term>Lymphoedème</term><term>Membre inférieur</term><term>Microchirurgie</term><term>Noeuds lymphatiques</term><term>Sujet âgé</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Collecting lymphatics have lymph-drainage function with contraction of smooth muscle cells. Patients with edema have lost this drainage function due to degeneration of smooth muscle cells. Lymphaticovenular (LV) anastomosis salvages smooth muscle cells from reversible degeneration (mild edema), but muscle cells cannot be recovered from irreversible degeneration (severe edema). Therefore, in severe edema, LV anastomoses cannot reestablish the drainage function of the lymphatic system.To overcome this weakness of LV bypass methods for severe edema, new methods were instituted for repair of this missing drainage function using a lymphadiposal flap from the contralateral foot for hemilateral edema, or transfer of lateral thoracic lymph nodes for bilateral edema.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26258914</PMID><DateCreated><Year>2016</Year><Month>01</Month><Day>07</Day></DateCreated><DateCompleted><Year>2016</Year><Month>10</Month><Day>07</Day></DateCompleted><DateRevised><Year>2016</Year><Month>12</Month><Day>30</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1098-8947</ISSN><JournalIssue CitedMedium="Internet"><Volume>32</Volume><Issue>1</Issue><PubDate><Year>2016</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Journal of reconstructive microsurgery</Title><ISOAbbreviation>J Reconstr Microsurg</ISOAbbreviation></Journal><ArticleTitle>Lymphadiposal Flaps and Lymphaticovenular Anastomoses for Severe Leg Edema: Functional Reconstruction for Lymph Drainage System.</ArticleTitle><Pagination><MedlinePgn>50-5</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1055/s-0035-1554935</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Collecting lymphatics have lymph-drainage function with contraction of smooth muscle cells. Patients with edema have lost this drainage function due to degeneration of smooth muscle cells. Lymphaticovenular (LV) anastomosis salvages smooth muscle cells from reversible degeneration (mild edema), but muscle cells cannot be recovered from irreversible degeneration (severe edema). Therefore, in severe edema, LV anastomoses cannot reestablish the drainage function of the lymphatic system.To overcome this weakness of LV bypass methods for severe edema, new methods were instituted for repair of this missing drainage function using a lymphadiposal flap from the contralateral foot for hemilateral edema, or transfer of lateral thoracic lymph nodes for bilateral edema.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A total of 13 cases were repaired with lymphadiposal flaps and additional LV anastomoses. These cases have frequent phlegmon or cellulitis or resisted to previous LV anastomoses and/or compression therapy. The ages ranged from 15 to 75 years. There were four cases of primary edema and nine cases of secondary edema.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Regarding the lymphadiposal flap (n = 8), three cases showed an excellent response (37.5%; no need for compression therapy), four cases had a good response (50%; improvement with compression), one case showed no change (12.5%; no improvement), and there were no cases of deterioration. Regarding the lateral thoracic lymph nodes transfer (n = 5), two cases had a good response (40%), three showed no improvement (60%), and there were no cases of deterioration.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">It is concluded that lymphadiposal flap or lymph nodes transfer is suitable for severe edema having frequent cellulitis in unilateral or bilateral lower extremities resisting previous LV anastomoses and/or compression therapy.</AbstractText><CopyrightInformation>Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Koshima</LastName><ForeName>Isao</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Narushima</LastName><ForeName>Mitsunaga</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mihara</LastName><ForeName>Makoto</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yamamoto</LastName><ForeName>Takumi</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hara</LastName><ForeName>Hisako</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ohshima</LastName><ForeName>Azusa</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kikuchi</LastName><ForeName>Kazuki</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Todokoro</LastName><ForeName>Ken</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Seki</LastName><ForeName>Yukio</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Iida</LastName><ForeName>Takuya</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nakagawa</LastName><ForeName>Masahiro</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Shizuoka Cancer Center, Tokyo and Shizuoka, Japan.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>08</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Reconstr Microsurg</MedlineTA><NlmUniqueID>8502670</NlmUniqueID><ISSNLinking>0743-684X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000714" MajorTopicYN="N">Anastomosis, Surgical</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D035002" MajorTopicYN="N">Lower Extremity</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008198" MajorTopicYN="N">Lymph Nodes</DescriptorName><QualifierName UI="Q000637" MajorTopicYN="Y">transplantation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></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="D013524" MajorTopicYN="Y">Surgical Flaps</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate 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