Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Efficacy and patient satisfaction regarding lymphovenous bypass with sleeve-in anastomosis for extremity lymphedema

  • Chung, Jae-Ho (Department of Plastic Surgery, Korea University Anam Hospital) ;
  • Baek, Si-Ook (Department of Plastic Surgery, Korea University Anam Hospital) ;
  • Park, Ho-Jin (Department of Plastic Surgery, Korea University Anam Hospital) ;
  • Lee, Byung-Il (Department of Plastic Surgery, Korea University Anam Hospital) ;
  • Park, Seung-Ha (Department of Plastic Surgery, Korea University Anam Hospital) ;
  • Yoon, Eul-Sik (Department of Plastic Surgery, Korea University Anam Hospital)
  • Received : 2018.07.03
  • Accepted : 2018.12.14
  • Published : 2019.01.15
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Abstract

Background When performing lymphovenous anastomosis, it is sometimes difficult to find venules in the proximity of an ideal lymphatic vessel that have a similar diameter to that of the lymphatic vessel. In this situation, larger venules can be used. Methods The authors evaluated the efficacy of and patient satisfaction with lymphovenous bypass with sleeve-in anastomosis. Between January 2014 and December 2016, we performed this procedure in 18 patients (eight upper extremities and 10 lower extremities) with secondary lymphedema. Lymphovenous bypass with sleeve-in anastomosis was performed under microscopy after injecting indocyanine green dye. The circumferential diameter was measured before lymphovenous bypass and at 1, 2, and 6 months after the procedure. An outcomes survey that included patients' qualitative satisfaction with lymphovenous bypass was conducted at 6 months postoperatively. Results Almost all patients showed quantitative improvements after surgery. The circumferential reduction rate in patients with stage II lymphedema of both the upper and lower extremities was significantly greater than in their counterparts with stage III/IV lymphedema. The circumferential reduction rate was lower in lower-extremity patients than in upper-extremity patients. Conclusions Lymphovenous bypass surgery with sleeve-in anastomosis in lymphedema patients is beneficial, and appears to be effective, when adequately-sized venules cannot be found in the proximity of an ideal lymphatic vessel.

Keywords

References

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