2003 Volume 14 Issue 1 Pages 25-30
The treatment of lymphedema is a difficult and challenging problem. We performed lymphatic-venous shunt (L-V shunt) for the lower limb lymphedema. The subjects included 12 cases, 13 limbs for which lymph vessel-great saphenous vein shunt was performed between 1993 and 2002.
The causes of the lower limb lymphedema broke down to 2 primary cases and after treatment of uterine cancer (surgery and radiotherapy) 10 cases. L-V shunt was performed under a surgical microscope in accordance with the Degni’s pull through method. Administration of anti-platelet agents, Hadomer and lymph induction massage were given to all cases after surgery. Evaluation was made by clinical symptoms and measurement of the perimeter of the lower limb at two weeks after operation.
The result were rated as markedly effective where the perimeter of the lower limb decreased more than 5cm, as effective where the perimeter decreased less than 5cm, as slightly effective where the perimeter remained unchanged but tissue became soft and as ineffective where there was no change. There were markedly effective 5 limbs, effective 3 limbs, slightly effective 3 limbs and ineffective 2 limbs. No postoperative complication was seen. The more shunts, the better results were obtained. The results were satisfactorily, the effective rate of surgery begin 84.6%. Oral administration of anti-platelet agents and lymph induction massage are considered necessary to keep edema improved.
