Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion.
<h4>Objective</h4>The number of bypasses is the most important factor in lymphaticovenular anastomosis (LVA) for lymphedema treatment. Side-to-end (S-E) LVA, which can bypass bidirectional lymph flows via one anastomosis, is considered to be the most efficient bypass, but creation of lat...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2013-01-01
|
Series: | PLoS ONE |
Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23536881/?tool=EBI |
id |
doaj-ea2b2272485940758af0d412d41a67bb |
---|---|
record_format |
Article |
spelling |
doaj-ea2b2272485940758af0d412d41a67bb2021-03-03T23:32:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0183e5952310.1371/journal.pone.0059523Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion.Takumi YamamotoHidehiko YoshimatsuNana YamamotoMitsunaga NarushimaTakuya IidaIsao Koshima<h4>Objective</h4>The number of bypasses is the most important factor in lymphaticovenular anastomosis (LVA) for lymphedema treatment. Side-to-end (S-E) LVA, which can bypass bidirectional lymph flows via one anastomosis, is considered to be the most efficient bypass, but creation of lateral window to a small lymphatic vessel is technically demanding. To overcome the difficulty, we introduced S-E anastomosis through temporary lymphatic expansion (SEATTLE) procedure in S-E LVA.<h4>Methods</h4>This was a retrospective observational study set in a teaching hospital. Forty eight lower extremity lymphedema (LEL) patients underwent LVA. S-E LVAs were performed with (SEATTLE group) or without (non-SEATTLE group) temporary lymphatic expansion. S-E LVAs were evaluated to compare anastomosis result in SEATTLE and non-SEATTLE groups.<h4>Results</h4>S-E LVAs resulted in 44 anastomoses in SEATTLE group (n = 25) and 37 anastomoses in non-SEATTLE group (n = 23). LEL index reduction in SEATTLE group was significantly greater than that in non-SEATTLE group (16.5±14.5 vs. 10.9±11.8, P = 0.041). Success rate of S-E LVA in SEATTLE group was significantly higher than that in non-SEATTLE group (95.5% vs 81.1%, P = 0.040). Thirty seven of 44 (84.1%) lymph vessels in SEATTLE group were successfully dilated by temporary lymphatic expansion maneuver. All of 9 failed S-E LVAs used a lymphatic vessel with diameter of 0.35 mm or smaller.<h4>Conclusions</h4>The SEATTLE procedure facilitates S-E LVA by a simple and easy maneuver. When the diameter of the lymphatic vessel is 0.35 mm or smaller even after the temporary lymphatic expansion maneuver, S-E LVA is not recommended due to relatively high failure rate.https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23536881/?tool=EBI |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Takumi Yamamoto Hidehiko Yoshimatsu Nana Yamamoto Mitsunaga Narushima Takuya Iida Isao Koshima |
spellingShingle |
Takumi Yamamoto Hidehiko Yoshimatsu Nana Yamamoto Mitsunaga Narushima Takuya Iida Isao Koshima Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion. PLoS ONE |
author_facet |
Takumi Yamamoto Hidehiko Yoshimatsu Nana Yamamoto Mitsunaga Narushima Takuya Iida Isao Koshima |
author_sort |
Takumi Yamamoto |
title |
Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion. |
title_short |
Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion. |
title_full |
Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion. |
title_fullStr |
Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion. |
title_full_unstemmed |
Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion. |
title_sort |
side-to-end lymphaticovenular anastomosis through temporary lymphatic expansion. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2013-01-01 |
description |
<h4>Objective</h4>The number of bypasses is the most important factor in lymphaticovenular anastomosis (LVA) for lymphedema treatment. Side-to-end (S-E) LVA, which can bypass bidirectional lymph flows via one anastomosis, is considered to be the most efficient bypass, but creation of lateral window to a small lymphatic vessel is technically demanding. To overcome the difficulty, we introduced S-E anastomosis through temporary lymphatic expansion (SEATTLE) procedure in S-E LVA.<h4>Methods</h4>This was a retrospective observational study set in a teaching hospital. Forty eight lower extremity lymphedema (LEL) patients underwent LVA. S-E LVAs were performed with (SEATTLE group) or without (non-SEATTLE group) temporary lymphatic expansion. S-E LVAs were evaluated to compare anastomosis result in SEATTLE and non-SEATTLE groups.<h4>Results</h4>S-E LVAs resulted in 44 anastomoses in SEATTLE group (n = 25) and 37 anastomoses in non-SEATTLE group (n = 23). LEL index reduction in SEATTLE group was significantly greater than that in non-SEATTLE group (16.5±14.5 vs. 10.9±11.8, P = 0.041). Success rate of S-E LVA in SEATTLE group was significantly higher than that in non-SEATTLE group (95.5% vs 81.1%, P = 0.040). Thirty seven of 44 (84.1%) lymph vessels in SEATTLE group were successfully dilated by temporary lymphatic expansion maneuver. All of 9 failed S-E LVAs used a lymphatic vessel with diameter of 0.35 mm or smaller.<h4>Conclusions</h4>The SEATTLE procedure facilitates S-E LVA by a simple and easy maneuver. When the diameter of the lymphatic vessel is 0.35 mm or smaller even after the temporary lymphatic expansion maneuver, S-E LVA is not recommended due to relatively high failure rate. |
url |
https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23536881/?tool=EBI |
work_keys_str_mv |
AT takumiyamamoto sidetoendlymphaticovenularanastomosisthroughtemporarylymphaticexpansion AT hidehikoyoshimatsu sidetoendlymphaticovenularanastomosisthroughtemporarylymphaticexpansion AT nanayamamoto sidetoendlymphaticovenularanastomosisthroughtemporarylymphaticexpansion AT mitsunaganarushima sidetoendlymphaticovenularanastomosisthroughtemporarylymphaticexpansion AT takuyaiida sidetoendlymphaticovenularanastomosisthroughtemporarylymphaticexpansion AT isaokoshima sidetoendlymphaticovenularanastomosisthroughtemporarylymphaticexpansion |
_version_ |
1714811470683832320 |