Factors affecting outcomes after supermicrosurgical lymphovenous anastomosis in a defined patient population.


Journal

Clinical hemorheology and microcirculation
ISSN: 1875-8622
Titre abrégé: Clin Hemorheol Microcirc
Pays: Netherlands
ID NLM: 9709206

Informations de publication

Date de publication:
2019
Historique:
pubmed: 29 9 2019
medline: 14 2 2020
entrez: 29 9 2019
Statut: ppublish

Résumé

The optimal surgical treatment for lymphedema is still subject of intensive research. Therefore, it is vital to investigate what significance lymphovenous anastomosis (LVA) has in this context. This study aims to determine the short- and long-term results as well as the most important factors that can improve outcomes after LVA. This study includes a complete data set of 26 patients who received LVA for a therapy-resistant lymphedema. Patients were followed up for an average of 23 months. 50% of the patients reported a subjective improvement. Without conservative treatment after the operation the patients showed significant better results (100% vs. 40.9%, p = 0.030). The localization of lymphedema as well as the region of LVA had a significant influence. In patients with lymphedema affecting the entire leg, symptom improvement was significantly lower (35.3% vs. 77.8%, p = 0.039). Patients who received LVA in an upper limb show a significantly higher improvement in symptoms than patients who received LVA in a lower limb (100% vs. 30%, p = 0.021). We identified factors with a significant influence on the outcome of patients after receiving LVA. Patients with early-stage upper extremity lymphedema seem to benefit most from this procedure.

Sections du résumé

BACKGROUND BACKGROUND
The optimal surgical treatment for lymphedema is still subject of intensive research. Therefore, it is vital to investigate what significance lymphovenous anastomosis (LVA) has in this context.
OBJECTIVE OBJECTIVE
This study aims to determine the short- and long-term results as well as the most important factors that can improve outcomes after LVA.
METHODS METHODS
This study includes a complete data set of 26 patients who received LVA for a therapy-resistant lymphedema. Patients were followed up for an average of 23 months.
RESULTS RESULTS
50% of the patients reported a subjective improvement. Without conservative treatment after the operation the patients showed significant better results (100% vs. 40.9%, p = 0.030). The localization of lymphedema as well as the region of LVA had a significant influence. In patients with lymphedema affecting the entire leg, symptom improvement was significantly lower (35.3% vs. 77.8%, p = 0.039). Patients who received LVA in an upper limb show a significantly higher improvement in symptoms than patients who received LVA in a lower limb (100% vs. 30%, p = 0.021).
CONCLUSIONS CONCLUSIONS
We identified factors with a significant influence on the outcome of patients after receiving LVA. Patients with early-stage upper extremity lymphedema seem to benefit most from this procedure.

Identifiants

pubmed: 31561341
pii: CH199213
doi: 10.3233/CH-199213
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

53-63

Auteurs

Eric Klingelhoefer (E)

Division of Plastic Surgery, Department of Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Goettingen, Germany.

Karl Hesse (K)

Division of Plastic Surgery, Department of Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Goettingen, Germany.

Christian D Taeger (CD)

Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Germany.

Lukas Prantl (L)

Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Germany.

Adam Stepniewski (A)

Division of Plastic Surgery, Department of Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Goettingen, Germany.

Gunther Felmerer (G)

Division of Plastic Surgery, Department of Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Goettingen, Germany.

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