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World Journal of Surgery

, Volume 28, Issue 6, pp 609–613 | Cite as

Microsurgical Techniques for Lymphedema Treatment: Derivative Lymphatic-Venous Microsurgery

  • Corradino Campisi
  • Francesco Boccardo
Original Scientific Reports

Abstract

We analyzed clinicopathologic and imaging features of chronic peripheral lymphedema to identify imaging findings indicative of its exact etiopathogenesis and to establish the optimal treatment strategy. One of the main problems of microsurgery for lymphedema is the discrepancy between the excellent technical possibilities and the subsequently insufficient reduction of the lymphedematous tissue fibrosis and sclerosis. Appropriate treatment based on pathologic studies and surgical outcome have not been adequately documented. Over the past 25 years, 676 patients with peripheral lymphedema have been treated with microsurgical lymphatic-venous anastomoses. Of these patients, 447 (66%) were available for long-term follow-up study. Objective assessment was undertaken by water volumetry and lymphoscintigraphy. Objectively, volume changes showed a significant improvement in 561 patients (83%), with an average reduction of 67% of the excess volume. Of the 447 patients followed, 380 (85%) have been able to discontinue the use of conservative measures, with an average follow-up of more than 7 years and average reduction in excess volume of 69%. There was an 87% reduction in the incidence of cellulitis after microsurgery. Microsurgical lymphatic-venous anastomoses have a place in the treatment of peripheral lymphedema and should be the therapy of choice in patients who are not sufficiently responsive to nonsurgical treatment. Improved results can be expected with operations performed early, during the first stages of lymphedema.

Keywords

Lymphedema Seminoma Excess Volume Secondary Branch Chylous Leakage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2004

Authors and Affiliations

  1. 1.Department of Specialistic Surgical Sciences, Anesthesiology, and Organ Transplants (DI.S.C.A.T.), Section of General and Emergency Surgery, Lymphology and Microsurgery CenterS. Martino Hospital, University of GenoaGenoaItaly

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