Biomaterial Database

Comparison of patency rates of lymphaticovenous anastomoses at different sites for lower extremity lymphedema. 2019

Yushi Suzuki, and Hisashi Sakuma, and Shun Yamazaki

Department of Plastic and Reconstructive Surgery, University of the Ryukyus, Okinawa, Japan. Electronic address: yushisuzuki-kei@umin.ac.jp.

OBJECTIVE Lymphaticovenous anastomosis (LVA) is one of the surgical treatments of lymphedema. However, only a few reports have evaluated LVA directly. This study aimed to evaluate the patency of LVA using indocyanine green fluorescence lymphography and to determine the optimal anastomosis site in patients with lower extremity lymphedema. METHODS Thirty-six patients, with a total of 123 anastomoses for lower extremity lymphedema including 3 cases of idiopathic lymphedema, who underwent LVA for the first time between March 2014 and March 2017 were selected for enrollment in this study. The patency of the anastomoses was evaluated using PDE-neo (Hamamatsu Photonics, Hamakita, Japan) by injecting indocyanine green into the subcutaneous tissue at 6 months postoperatively. The site of anastomosis was the intersection point of the lymphatic vessel and vein, which was identified preoperatively. To determine the best surgical location, the anastomosis site was classified into the joint area (ankle and knee) and nonjoint area (dorsum and lower leg). The anastomosis was evaluated as either patent or nonpatent. RESULTS Patency was confirmed in 37 of the 76 (49%) anastomoses at the joint area and 12 of the 47 (26%) at nonjoint areas (P = .01). CONCLUSIONS The patency rate was significantly higher around the joint area than at the nonjoint areas. LVA around the joint area is recommended to ensure favorable technical and surgical outcomes for patients with lower extremity lymphedema.

UI	MeSH Term	Description	Entries
D007208	Indocyanine Green	A tricarbocyanine dye that is used diagnostically in liver function tests and to determine blood volume and cardiac output.	Cardio-Green,Cardiogreen,Ujoveridin,Vofaverdin,Vophaverdin,Wofaverdin,Cardio Green,Green, Indocyanine
D008209	Lymphedema	Edema due to obstruction of lymph vessels or disorders of the lymph nodes.	Milroy's Disease,Congenital Familial Lymphedema,Congenital Hereditary Lymphedema,Early Onset Lymphedema,Hereditary Lymphedema,Hereditary Lymphedema 1,Hereditary Lymphedema Type I,Lymphedema, Early-Onset,Lymphedema, Hereditary, Ia,Milroy Disease,Nonne-Milroy Disease,Nonne-Milroy Lymphedema,Nonne-Milroy-Meige Disease,Primary Congenital Lymphedema,Congenital Hereditary Lymphedemas,Congenital Lymphedema, Primary,Congenital Lymphedemas, Primary,Early Onset Lymphedemas,Early-Onset Lymphedema,Early-Onset Lymphedemas,Hereditary Lymphedema 1s,Hereditary Lymphedema, Congenital,Hereditary Lymphedemas,Hereditary Lymphedemas, Congenital,Lymphedema, Congenital Hereditary,Lymphedema, Early Onset,Lymphedema, Hereditary,Lymphedema, Nonne-Milroy,Lymphedema, Primary Congenital,Lymphedemas,Lymphedemas, Congenital Hereditary,Lymphedemas, Early Onset,Lymphedemas, Early-Onset,Lymphedemas, Hereditary,Lymphedemas, Primary Congenital,Milroys Disease,Nonne Milroy Disease,Nonne Milroy Lymphedema,Nonne Milroy Meige Disease,Primary Congenital Lymphedemas
D008220	Lymphography	Radiographic study of the lymphatic system following injection of dye or contrast medium.	Lymphangiography,Lymphangiographies,Lymphographies
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D005260	Female		Females
D005456	Fluorescent Dyes	Chemicals that emit light after excitation by light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags.	Flourescent Agent,Fluorescent Dye,Fluorescent Probe,Fluorescent Probes,Fluorochrome,Fluorochromes,Fluorogenic Substrates,Fluorescence Agents,Fluorescent Agents,Fluorogenic Substrate,Agents, Fluorescence,Agents, Fluorescent,Dyes, Fluorescent,Probes, Fluorescent,Substrates, Fluorogenic
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly