下肢リンパ浮腫に対するリンパ管静脈吻合術の超早期効果～MRIによる定量的解析および術翌日治療成績

抄録

  Background: This retrospective study aimed to assess the surgical impact of lymphaticovenous anastomosis (LVA) in lower extremity lymphedema by excluding the influence of conservative therapies and self-management. Instead of limb circumference, magnetic resonance imaging (MRI) was employed for quantitative analysis to minimize potential measurement bias.　
  Methods: A total of 77 patients (87 limbs) with no previous lymphedema surgeries were divided into two groups: multisite LVA (M-LVA, n = 34) and single LVA (S-LVA, n = 53) . Plain MRI was obtained preoperatively and 1 day postoperatively. The cross-sectional area of each affected limb was measured at two axial slices, and the MR change rate (%) was calculated using the following formula: (Σpostoperative areas -Σpreoperative areas) /Σpreoperative areas×100.　
  Results: The mean number of anastomoses was 2.9 and 1.0, and the mean MR change rate was -9.5%［±4.90 standard deviation (SD) ］and -6.6% (±2.92 SD) in the M-LVA and S-LVA groups, respectively. MR change rate was significantly higher in the M-LVA group (Welch’s t test, p < 0.005) than in the S-LVA group.　
  Conclusions: We found that LVA had an immediate edema reduction effect in both the M-LVA and S-LVA groups. M-LVA may have greater efficacy than S-LVA.