Annals of Vascular Diseases
Online ISSN : 1881-6428
Print ISSN : 1881-641X
ISSN-L : 1881-641X
Series: Lymphology from the Journal of Japanese College of Angiology
Recent Advancement on Surgical Treatments for Lymphedema
Isao KoshimaMitsunaga NarushimaYusuke YamamotoMakoto MiharaTakuya Iida
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2012 Volume 5 Issue 4 Pages 409-415

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Abstract

Treatment for limb lymphedema is challenging. The recent development of the super-microsurgical technique has made lymphaticovenular (LV) anastomosis an easier and more accurate surgical method for lymphedema. A summary of our experience as well as recent developments in surgical treatments for lymphedema are described.Methods and Results: Ultra-microstructural analysis demonstrated that dysfunction of the lymphatics in lymphedema was caused by the degeneration and incomplete regeneration of smooth muscle cells and valve insufficiency in the lymphatic channel. ICG and infrared ray examinations have been proposed as new means of assessment of lymphatic function. LV anastomosis is suitable for genital edema, arm edema with severe phlegmone with leg edema, and early stage leg edema. Although pre- and postoperative compression therapy is generally required for limb edema, some cases do not require postoperative compression due to remaining or regenerated smooth muscle cells. As new methods of treatment, the vascularized lymphadiposal flap has been effective for progressive cases with LV anastomosis. LV anastomosis is also effective for congenital chyloabdomen. (*English Translation of J Jpn Coll Angiol 2008; 48: 173-178.)

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© 2012 Annals of Vascular Diseases

この記事はクリエイティブ・コモンズ [表示 - 非営利 - 継承 4.0 国際]ライセンスの下に提供されています。
https://creativecommons.org/licenses/by-nc-sa/4.0/deed.ja
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