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Lymphaticovenular anastomosis

Giuseppe Visconti, Takumi Yamamoto, Nobuko Hayashi, Akitatsu Hayashi
No abstract text is available yet for this article.
February 16, 2017: Plastic and Reconstructive Surgery
Theodore A Kung, Manish C Champaneria, Jeffrey H Maki, Peter C Neligan
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Discuss the key points in diagnosing lymphedema. 2. Understand the imaging modalities that facilitate diagnosis and surgical planning. 3. Appreciate the indications for both physiologic and ablative procedures. 4. Recognize the potential role of lymphaticovenular anastomosis and vascularized lymph node transfer in the treatment of patients with lymphedema. SUMMARY: Lymphedema is an incurable disease caused by insufficient lymphatic drainage leading to abnormal accumulation of interstitial fluid within the soft tissues...
April 2017: Plastic and Reconstructive Surgery
P Gennaro, G Gabriele, C Salini, G Chisci, F Cascino, J-F Xu, C Ungari
OBJECTIVE: Aim of this paper is to present our reduction of the frequency of cellulitis before and after supramicrosurgical lymphaticovenular anastomosis (s-LVA) in lymphoedema patients, and discuss the possibility to perform this technique outside Japan. PATIENTS AND METHODS: 37 patients affected by lymphoedema were enrolled. All patients received preoperative indocyanine green lymphography. Under local anaesthesia s-LVA was performed on all patients. All patients were followed for 1 year...
February 2017: European Review for Medical and Pharmacological Sciences
Harm Winters, Hanneke J P Tielemans, Philippe N Sprangers, Dietmar J O Ulrich
BACKGROUND: Lymphaticovenular anastomosis (LVA) is a supermicrosurgical procedure that involves the anastomosis of a functional lymphatic channel to a venule. Although peri-operative care might be an important contributor to the success of this technique, evidence about optimal peri-operative care seems limited. This review aims to summarize the peri-operative methods used by authors reporting on LVA. METHODS: A systematic search of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
February 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
P Gennaro, G Gabriele, M Mihara, K Kikuchi, C Salini, I Aboh, F Cascino, G Chisci, C Ungari
OBJECTIVE: Lymphoedema of the extremities is a widespread pathological condition that mostly occurs as a complication of cancer resections, especially in women. Conventional therapy refers to conservative and physiotherapeutic approaches. Surgical strategies have been widely reported in the literature and are still challenging. Part of this literature focuses on the supra microsurgical lymphaticovenular anastomosis (LVA) technique. LVA is characterized by a high success rate, minimal invasivity and broad indications...
November 2016: European Review for Medical and Pharmacological Sciences
Satoshi Onoda, Kiyoshi Yamada, Kumiko Matsumoto, Yoshihiro Kimata
Background To date, only a few reports have been published on idiopathic lymphedema, and most of these are case reports. In this time, we performed a retrospective review of idiopathic lymphedema patients. Methods Forty patients presented with idiopathic lymphedema that was unrelated to surgery, injury, and medical conditions such as circulatory disease, kidney disease, and thrombotic venous disease. For these patients, we performed a retrospective review for edema-onset age, sex, location and stage of the edema, presence of cellulitis, episode related to edema onset, therapeutic intervention, and follow-up duration in the 33 patients whom we followed up...
January 2017: Journal of Reconstructive Microsurgery
Wei F Chen, Haidong Zhao, Takumi Yamamoto, Hisako Hara, Johnson Ding
Background Microsurgical vascularized lymph node transfer (VLNT) and supermicrosurgical lymphaticovenular anastomosis (LVA) are increasingly performed to treat lymphedema. The surgical outcome is commonly assessed by volume-based measurement (VBM), a method that is not consistently reliable. We describe indocyanine green (ICG) lymphography as an alternative postoperative tracking modality after lymphatic reconstruction with VLNT and LVA. Methods VLNT and LVA were performed in patients with therapy-refractory lymphedema...
November 2016: Journal of Reconstructive Microsurgery
Makoto Mihara, Hisako Hara, Shuichi Tange, Han Peng Zhou, Mari Kawahara, Yohei Shimizu, Noriyuki Murai
BACKGROUND: The impact of lymphaticovenous anastomosis on lymphedema has yet to be defined. The authors investigated the clinical evidence regarding the effectiveness of lymphaticovenous anastomosis in lower limb lymphedema. METHODS: Eighty-four patients (162 limbs; 73 female and 11 male patients) with lower limb lymphedema who underwent multisite lymphaticovenous anastomosis in the authors' clinic between August of 2010 and May of 2014 were included in this retrospective study...
July 2016: Plastic and Reconstructive Surgery
Satoshi Onoda, Yoshihiro Kimata, Kumiko Matsumoto, Kiyoshi Yamada, Eijiro Tokuyama, Narushi Sugiyama
BACKGROUND: Lymphaticovenular anastomosis plays an important role in the surgical treatment of lymphedema. The outcomes of lymphaticovenular anastomosis are evaluated based on changes in edema; however, isolated assessment of the anastomosis itself is difficult. The authors used an animal experimental model to conduct a detailed examination of histologic changes associated with lymphaticovenular anastomosis and determined the factors important for success. METHODS: The experimental lymphaticovenular anastomosis model was created using lumbar lymph ducts and iliolumbar veins of Wistar rats...
January 2016: Plastic and Reconstructive Surgery
Takumi Yamamoto, Hidehiko Yoshimatsu, Nana Yamamoto, Ai Yokoyama, Takao Numahata, Isao Koshima
BACKGROUND: Lymphaticovenular anastomosis (LVA) is becoming a treatment option for lymphedema. It is challenging to perform LVA when a lymphatic vessel is too far from a vein to anastomose directly. METHODS: We applied vein grafting for simultaneous multisite LVA (SM-LVA), when there was a considerable distance between a lymphatic vessel and a vein. Five patients with lower extremity lymphedema (LEL) who underwent SM-LVA were included in this study. Feasibility and treatment effect of the method were evaluated...
October 2015: Vascular and Endovascular Surgery
Yukio Seki, Takumi Yamamoto, Hidehiko Yoshimatsu, Akitatsu Hayashi, Arito Kurazono, Masanori Mori, Yoichi Kato, Isao Koshima
BACKGROUND: Lymphatic vessel diameter and lymph flow are important for accurate anastomosis and effective lymph-to-venous flow in lymphaticovenular anastomosis. The authors developed a reliable method, the superioredge-of-the-knee incision method, for detecting and making the best use of high-flow lymphatic vessels in the distal medial thigh between the deep and superficial fascia, where movement of the knee, combined with compression between these fascial layers, theoretically results in upward propulsion of lymphatic fluid...
November 2015: Plastic and Reconstructive Surgery
Pengju Shi, Wenlong Zhang, Gang Zhao, Liang Li, Cai Haifeng
OBJECTIVE: To investigate the therapeutic effect of modified side-to-end lymphaticovenular anastomosis in the treatment of post-mastectomy upper limb lymphedema. METHODS: Between May 2010 and May 2011, 11 female patients with post-mastectomy upper limb lymphedema underwent a modified side-to-end lymphaticovenular anastomosis. The average age was 49.5 years (range, 38-55 years). Lymphedema occurred at 7-30 months (mean, 18.3 months) after resection of breast cancer, with an average disease duration of 25...
March 2015: Chinese Journal of Reparative and Reconstructive Surgery
Mitsunaga Narushima, Takumi Yamamoto, Fusa Ogata, Hidehiko Yoshimatsu, Makoto Mihara, Isao Koshima
BACKGROUND AND METHODS: Indocyanine green (ICG) lymphography is one of several methods of lymphography to detect lymphatic channels and evaluate patients clinically with limb lymphedema. ICG imaging is made possible by the use of a near-infrared camera device. The fluorescence images were digitalized for real-time display. RESULTS: ICG lymphography findings are largely classifiable into two patterns: normal linear pattern and abnormal dermal backflow (DB) pattern...
January 2016: Journal of Reconstructive Microsurgery
Isao Koshima, Mitsunaga Narushima, Makoto Mihara, Takumi Yamamoto, Hisako Hara, Azusa Ohshima, Kazuki Kikuchi, Ken Todokoro, Yukio Seki, Takuya Iida, Masahiro Nakagawa
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...
January 2016: Journal of Reconstructive Microsurgery
Satoshi Onoda, Yoshihiro Kimata, Kumiko Matsumoto
INTRODUCTION: Lymphaticovenular anastomosis (LVA) has become an important procedure for the surgical treatment of lymphedema. In the past, the anatomy of the lymphatic system of animal models has been reported. However, to our knowledge, there have been few reports of animal models of LVA including training model. In this study, we report on a relatively simple and ideal animal LVA model based on peritoneal lymph ducts and veins. PATIENTS AND METHODS: For 10 rats, diameters of lumbar lymphatic ducts and iliolumbar veins in the peritoneal cavity on both sides were measured, and LVA was performed...
March 2016: Annals of Plastic Surgery
Wei F Chen, Takumi Yamamoto, Mark Fisher, Junlin Liao, Jennifer Carr
BACKGROUND: Supermicrosurgical lymphaticovenular anastomosis (LVA) is a promising treatment modality for lymphedema. However, its practice is restricted by the surgeon/equipment-related factors, and its effectiveness limited by technical constraints. We conducted a pilot study to evaluate the feasibility of a modified "octopus" LVA technique in addressing the above problems. METHOD: Nine consecutive lymphedema patients underwent LVA procedure using the "octopus" technique...
July 2015: Journal of Reconstructive Microsurgery
Lee M Mitsumori, Elizabeth S McDonald, Gregory J Wilson, Peter C Neligan, Satoshi Minoshima, Jeffrey H Maki
Lymphedema is a chronic progressive edematous disease that in the United States is most commonly related to malignancy and its treatment. Lymphaticovenular anastomosis is a recently introduced microsurgical treatment option for lymphedema that requires the identification and mapping of individual lymphatic channels. While nuclear medicine lymphoscintigraphy has been the primary imaging modality performed to evaluate suspected lymphedema, lymphoscintigraphy does not provide the spatial information necessary for presurgical planning...
December 2015: Journal of Magnetic Resonance Imaging: JMRI
Shinsuke Akita, Nobuyuki Mitsukawa, Motone Kuriyama, Yoshitaka Kubota, Masakazu Hasegawa, Hideki Tokumoto, Tatsuya Ishigaki, Takashi Togawa, Junpei Kuyama, Kaneshige Satoh
BACKGROUND: Vascularized lymph node transfer has become a popular surgical option to improve lower extremity lymphedema (LEL), although potential donor sites are limited. The free supraclavicular flap with deep cervical lymph nodes has been recently associated with a minimal risk of secondary lymphedema caused by donor site dissection. However, the effectiveness of this procedure has not yet been evaluated. METHODS: Vascularized supraclavicular lymph node transfer (VSLNT) was performed for patients with International Society of Lymphology late stage II or more severe LEL...
May 2015: Annals of Plastic Surgery
Akitatsu Hayashi, Takumi Yamamoto, Hidehiko Yoshimatsu, Nobuko Hayashi, Megumi Furuya, Mitsunobu Harima, Mitsunaga Narushima, Isao Koshima
BACKGROUND: Identification of lymphatic vessels for lymphaticovenular anastomosis (LVA), which is an effective surgical treatment for obstructive lymphedema, is important. Indocyanine green (ICG) lymphography is useful for that purpose, but is not common in many institutions. Although ultrasound is a very common modality, no research has yet underlined the feasibility of the device to detect the lymphatic vessels. METHODS: First, identification of lymphatic vessels in the lower legs using ultrasound was performed in non-edematous limbs with linear-pattern on ICG lymphography (n = 12)...
April 8, 2015: Microsurgery
Takumi Yamamoto, Nana Yamamoto, Akitatsu Hayashi, Isao Koshima
Lymphatic supermicrosurgery or supermicrosurgical lymphaticovenular anastomosis (LVA) is becoming popular for the treatment of compression-refractory upper extremity lymphedema (UEL) with its effectiveness and minimally invasiveness. In conventional LVA, superficial lymphatic vessels are used for anastomosis, but its treatment efficacy would be minimum when superficial lymphatic vessels are severely sclerotic. Theoretically, deep lymphatic vessels can be used for LVA, but no clinical case has been reported regarding deep lymphatic vessel-to-venous anastomosis (D-LVA)...
February 2017: Microsurgery
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