Objective Assessment of the Efficacy of Supermicrosurgical Lymphaticovenous Anastomosis and Microsurgical Lymphaticovenous Implantation in a Case of Axillary Lymphorrhea

ABSTRACT

Supermicrosurgical lymphaticovenous anastomosis and microsurgical lymphaticovenous implantation are procedures currently used to treat lymphedema. However, because in most cases concomitant conservative treatments are included, it is difficult to objectively assess the direct effect of the procedures. The present report is a case in which supermicrosurgical lymphaticovenous anastomosis and microsurgical lymphaticovenous implantation were performed to treat axillary lymphorrhea that developed after the treatments for lymph node metastases of esophageal carcinoma. Prior to surgery, the volume of lymphorrhea was ~300 mL/d, but from postoperative day 1, this amount decreased by half, and healing was obtained by postoperative day 20. This result objectively indicates that creating new lymphatic routes with these two procedures is clearly effective.

Lymphorrhea - lymphedema - supermicrosurgical lymphaticovenous anastomosis - microsurgical lymphaticovenous implantation

REFERENCES

• 1 Nielubowicz J, Olszewsky W. Surgical lymphatico-venous shunt in patients with secondary lymphedema.  Br J Surg. 1968;  55 440-442
• 2 O'Brien B M, Sykes P J, Threlfall G N. Microlymphaticovenous anastomoses for obstructive lymphedema.  Plast Reconst Surg. 1977;  60 197-211
• 3 Baumeister R G, Seifert J, Wiebecke B et al.. Experimental basis and first application of clinical lymphvessel transplantation of secondary lymphedema.  World J Surg. 1981;  5 401-407
• 4 Campisi C. Use of autologous interposition vein graft in management of lymphedema; preliminary experimental and clinical observations.  Lymphology. 1991;  24 71-76
• 5 Koshima I, Inagawa K, Urushibara K et al.. Supermicrosurgical lymphaticovenular anastomosis for the treatment of lymphedema in the upper extremities.  J Reconstr Microsurg. 2000;  16 437-442
• 6 Yamamoto Y, Sugihara T. Microsurgical lymphaticovenous implantation for the treatment of chronic lymphedema.  Plast Reconstr Surg. 1998;  101 157-161