Technical pearls in lymphatic supermicrosurgery.
bypass
cancer
lymphaticovenular anastomosis
lymphedema
microsurgery
supermicrosurgery
Journal
Global health & medicine
ISSN: 2434-9194
Titre abrégé: Glob Health Med
Pays: Japan
ID NLM: 101771579
Informations de publication
Date de publication:
29 Feb 2020
29 Feb 2020
Historique:
received:
29
07
2019
revised:
28
01
2020
accepted:
29
01
2020
entrez:
17
12
2020
pubmed:
18
12
2020
medline:
18
12
2020
Statut:
ppublish
Résumé
Lymphedema is becoming a major public issue with improvement of cancer survival rate, as the disease is incurable and progressive in nature, and the number of cancer survivor with lymphedema is increasing over time. Surgical treatment is recommended for progressive lymphedema, especially when conservative therapies are ineffective. Among various lymphedema surgeries, supermicrosurgical lymphaticovenular anastomosis (LVA) is becoming popular with its effectiveness and least invasiveness. There are many technical knacks and pitfalls in LVA surgery. In preoperative evaluation, indocyanine green lymphography is recommended for considering indication and incision sites. Intraoperatively, intravascular stenting method, temporary lymphatic expansion maneuver, field-rotating retraction, and several navigation methods are useful. The most important postoperative care is immediate compression after LVA surgery. Compression is critical to keep lymphatic pressure higher than venous pressure, allowing continuous lymph-to-venous bypass flow. These technical pearls should be shared with lymphedema surgeons for better lymphedema management.
Identifiants
pubmed: 33330771
doi: 10.35772/ghm.2019.01010
pmc: PMC7731411
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
29-32Informations de copyright
2020, National Center for Global Health and Medicine.
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