Flow-oriented Venous Anastomosis to Control Lymph Flow of Lymphatic Malformation
Background:. Less-invasive surgeries, such as lymphaticovenular anastomosis (LVA), are the widely accepted intervention for lymphedema. This study aimed to assess the outcomes of flow-oriented LVA modification on lymphatic malformation (LM). Methods:. We included 19 patients diagnosed with LM mixe...
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Wolters Kluwer
2019-07-01
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Series: | Plastic and Reconstructive Surgery, Global Open |
Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002199 |
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doaj-cce6f382f31a4f2ba461c526cad5347c2020-11-25T03:55:16ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742019-07-0177e219910.1097/GOX.0000000000002199201907000-00007Flow-oriented Venous Anastomosis to Control Lymph Flow of Lymphatic MalformationMotoi Kato, MD0Shoji Watanabe, MD, PhD1Azusa Watanabe, MD2Takuya Iida, MD, PhD3From *Department of Plastic and Reconstructive Surgery, Saitama Children’s Medical Center, Saitama, JapanFrom *Department of Plastic and Reconstructive Surgery, Saitama Children’s Medical Center, Saitama, JapanFrom *Department of Plastic and Reconstructive Surgery, Saitama Children’s Medical Center, Saitama, Japan†Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan.Background:. Less-invasive surgeries, such as lymphaticovenular anastomosis (LVA), are the widely accepted intervention for lymphedema. This study aimed to assess the outcomes of flow-oriented LVA modification on lymphatic malformation (LM). Methods:. We included 19 patients diagnosed with LM mixed type or microcystic type, who came to our clinic from June 2015 to December 2017. Under general anesthesia, all patients were administered an indocyanine green lymphography injection subcutaneously. In the case of a strong inflow, the patient underwent afferent lymph vessel of LM to venous anastomosis (LMVA). Otherwise, the side wall of LMVA was performed to the cysts. Outcomes were classified into the following groups based on the size changes: treatment effect (TE) 4 = >80% reduction rate; TE 3 = 50%–80% reduction rate; TE 2 = 20%–50% reduction rate; and TE 1 = 0%–20% reduction rate. Results:. All cases underwent surgery, with no case having an increased size. The results were as follows: TE 4 = 4 (21%) patients; TE 3 = 6 (32%) patients; TE 2 = 5 (26%) patients; and TE 1 = 4 (21%) patients. No case required study termination due to disease progression. Minor complication occurred in 3 cases. One vesicle increased at the labial mucosa and one wound dehiscence that epithelized within 1 month. Conclusion:. LMVA could be a novel, minimally invasive lymph flow-oriented surgical method for intractable LM.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002199 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Motoi Kato, MD Shoji Watanabe, MD, PhD Azusa Watanabe, MD Takuya Iida, MD, PhD |
spellingShingle |
Motoi Kato, MD Shoji Watanabe, MD, PhD Azusa Watanabe, MD Takuya Iida, MD, PhD Flow-oriented Venous Anastomosis to Control Lymph Flow of Lymphatic Malformation Plastic and Reconstructive Surgery, Global Open |
author_facet |
Motoi Kato, MD Shoji Watanabe, MD, PhD Azusa Watanabe, MD Takuya Iida, MD, PhD |
author_sort |
Motoi Kato, MD |
title |
Flow-oriented Venous Anastomosis to Control Lymph Flow of Lymphatic Malformation |
title_short |
Flow-oriented Venous Anastomosis to Control Lymph Flow of Lymphatic Malformation |
title_full |
Flow-oriented Venous Anastomosis to Control Lymph Flow of Lymphatic Malformation |
title_fullStr |
Flow-oriented Venous Anastomosis to Control Lymph Flow of Lymphatic Malformation |
title_full_unstemmed |
Flow-oriented Venous Anastomosis to Control Lymph Flow of Lymphatic Malformation |
title_sort |
flow-oriented venous anastomosis to control lymph flow of lymphatic malformation |
publisher |
Wolters Kluwer |
series |
Plastic and Reconstructive Surgery, Global Open |
issn |
2169-7574 |
publishDate |
2019-07-01 |
description |
Background:. Less-invasive surgeries, such as lymphaticovenular anastomosis (LVA), are the widely accepted intervention for lymphedema. This study aimed to assess the outcomes of flow-oriented LVA modification on lymphatic malformation (LM).
Methods:. We included 19 patients diagnosed with LM mixed type or microcystic type, who came to our clinic from June 2015 to December 2017. Under general anesthesia, all patients were administered an indocyanine green lymphography injection subcutaneously. In the case of a strong inflow, the patient underwent afferent lymph vessel of LM to venous anastomosis (LMVA). Otherwise, the side wall of LMVA was performed to the cysts. Outcomes were classified into the following groups based on the size changes: treatment effect (TE) 4 = >80% reduction rate; TE 3 = 50%–80% reduction rate; TE 2 = 20%–50% reduction rate; and TE 1 = 0%–20% reduction rate.
Results:. All cases underwent surgery, with no case having an increased size. The results were as follows: TE 4 = 4 (21%) patients; TE 3 = 6 (32%) patients; TE 2 = 5 (26%) patients; and TE 1 = 4 (21%) patients. No case required study termination due to disease progression. Minor complication occurred in 3 cases. One vesicle increased at the labial mucosa and one wound dehiscence that epithelized within 1 month.
Conclusion:. LMVA could be a novel, minimally invasive lymph flow-oriented surgical method for intractable LM. |
url |
http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002199 |
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