下肢リンパ管細静脈吻合術後に集中排液を行った症例の術後1年間の患肢体液量の変化と著効例の背景因子

抄録

  ［Background］We examined the efficacy of lower limb lymphaticovenular anastomosis (LVA) combined with postoperative reduction treatment (PORT) in reducing lymphedema during the first postoperative year.　
  ［Methods］Female patients with unilateral leg lymphedema who had undergone leg LVA with 7 days of PORT were included. Patients were selected for whom body water volume data were available at six points in time: preoperatively; at discharge; and 1, 3, 6, and 12 months postoperatively. Patients were divided into two groups according to the change in postoperative water volume reduction in the affected leg: those with maintenance of body water volume below the preoperative level, termed as “maximum efficacy”, and those without.　
  ［Results］Of the 28 eligible cases, 14 demonstrated maximum efficacy with LVA. The first peak of water volume reduction in cases with maximum efficacy was at the time of discharge, with a transient regression observed following discharge. Thereafter, the water volume decreased, reapproaching the discharge value. Greater preoperative leg water volume was a common factor for cases with maximum efficacy (odds ratio: 3.351, 95% confidence interval: 1.215-9.240, p = 0.019) .　
  ［Conclusion］The leg water volume of LVA cases with maximum efficacy increased after discharge but returned to discharge values over the first postoperative year.