Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Lymphaticovenular Anastomosis: Superficial Venous Anatomical Approach

  • Winaikosol, Kengkart (Plastic and Reconstructive Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University) ;
  • Surakunprapha, Palakorn (Plastic and Reconstructive Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University)
  • Received : 2021.10.01
  • Accepted : 2022.07.26
  • Published : 2022.09.15
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Abstract

Background Lymphaticovenular anastomosis (LVA) is an effective, functional treatment for limb lymphedema. This study reports an alternative surgical approach to lymphedema treatment without the use of indocyanine green mapping. Methods A retrospective analysis was performed on 29 consecutive lymphedema patients who underwent LVAs from January 2015 to December 2020, whereby incisions were made along the anatomy of the superficial venous systems in both upper and lower extremities around the joint areas. The evaluation included qualitative assessments and quantitative volumetric analyses. Result The mean number of anastomoses was 3.07, and the operative time was 159.55 minutes. Symptom improvement was recorded in 86.21% of the patients, with a mean volume reduction of 32.39%. The lymphangitis episodes decreased from 55.17% before surgery to 13.79% after surgery, and the median number of lymphangitis episodes per year decreased from 1 before surgery to 0 after surgery. Conclusions The superficial venous anatomical approach is an easy way to start a lymphedema practice using LVA without other advanced surgical equipment. With this reliable technique, microsurgeons can perform LVA procedures and achieve good results.

Keywords

Acknowledgement

The authors thank Mr. Kevin McCracken for assistance with the English language presentation under the aegis of the Khon Kaen University Publication Clinic, Thailand.

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