Experimental basis and first application of clinical lymph vessel transplantation of secondary lymphedema
- 62 Downloads
Lymphedemas due to a blockage of the lymph vessels in the root of the extremities were treated experimentally and clinically by autotransplantation of lymph vessels under the operating microscope. In experimental lymphedema of the hind leg of 10 dogs, an increased circumference of about 50% was reduced to 10% within 7 weeks by lymph vessel transplantation. After removal of the transplants, the circumferences returned to pre-transplantation values. The pre-transplantation elevated intralymphatic pressure of 12.5 torr (controls: 2.5 torr) was reduced to the normal range of 3.5 torr after the transplantation. In 8 of 10 dogs, the patency of the transplants could be demonstrated by inspection, lymphography, and isotope injections. In all 10 dogs, patency could be proved by histologic examination. The data indicate that lymph vessel transplantation can restore the diminished lymph-transporting capacity brought on by lymphedema.
In 2 patients, it was possible to prepare lymph collectors about 25 cm long. After the transplantation, the circumferences diminished. By isotopes improved lymphatic transport could be demonstrated after the operation. Autologous transplantation of lymph vessels is a promising method for the treatment of secondary lymphedema especially in the early stages.
KeywordsHistologic Examination Lymph Vessel Lymphedema Promising Method Experimental Basis
Unable to display preview. Download preview PDF.
- 1.Földi, M.: Physiology and pathophysiology of lymphflow. In Lymphedema, L. Clodius, editor, Stuttgart, Georg Thieme Publishers, 1977, pp. 1–11Google Scholar
- 2.Clodius, L., Wirth, W.: A new experimental model for chronic lymphedema of the extremities. Chir Plast (Berl.)2:115, 1974Google Scholar
- 3.Baumeister, R.G.H., Seifert, J., Wiebecke, B.: Transplantation of lymph vessels on rats as well as a first therapeutic application on the experimental lymphedema of the dog. Eur. Surg. Res.12[Suppl. 2]:7, 1980Google Scholar
- 4.Olszewski, W.L.: Collection and physiological measurements of peripheral lymph and interstitial fluid in man. Lymphology10:137, 1977Google Scholar
- 5.Clodius, L.: The experimental basis for the surgical treatment of lymphedema. In Lymphedema, L. Clodius, editor, Stuttgart, Georg Thieme Publishers, 1977, pp. 43–77Google Scholar
- 6.Olszewski W.: On the pathomechanism of development of postsurgical lymphedema. Lymphology5:35, 1973Google Scholar
- 7.Casley-Smith, J.R.: A fine structural study of the removal of the effectiveness of benzo-pyrone treatment of lymphedema by the destruction of the macrophages by silica. Br. J. Exp. Pathol.59(2): 116, 1978Google Scholar
- 8.Piller, N.B.: Lymphedema, macrophages and benzopyrones. Lymphology13:109, 1980Google Scholar
- 9.Nielubowicz, J., Olszewski, W.: Surgical lymphovenous shunts for decompression of secondary lymphoedema. J. Cardiovasc. Surg. (Spec. Issue) 1966Google Scholar
- 10.O'Brien, B.M., Shafiroff, B.B.: Microlymphaticovenous and resectional surgery in obstructive lymphedema. World J. Surg.3:3, 1979Google Scholar
- 11.Degni, M.: New technique of lymphatic-venous anastomosis for the treatment of lymphedema. J. Cardiovasc. Surg. (Torino)19(5):577, 1978Google Scholar
- 12.Edwards, J.M., Kinmonth, J.B.: Lymphovenous shunt in man. Br. Med. J.4:579, 1969Google Scholar
- 13.Yamada, Y.: The study of lymphatic venous anastomosis in lymphedema. Nagoya J. Med.32:1969Google Scholar
- 14.Yoffey, J.M., Courtice, F.C.: Lymphatics, Lymph and the Lymphomyeloid Complex, London-New York, Academic Press, 1970Google Scholar
- 15.Clodius, L.: Invited commentary on “Microlymphaticovenous and resectional surgery in obstructive lymphedema.” World J. Surg.3:121, 1979Google Scholar