Lymphaticovenous anastomosis for facial lymphoedema after multiple courses of therapy for head-and-neck cancer

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• 作者：Makoto Mihara ; ^a ; ^{mihara@keiseigeka.name"" rel=""nofollow} ; Gentaro Uchida^a ; Hisako Hara^a ; Yohei Hayashi^a ; Hisashi Moriguchi^a ; Mitsunaga Narushima^a ; Takuya Iida^a ; Takumi Yamamoto^a ; Isao Koshima^a
• 关键词：Facial lymphoedema ; Lymphaticovenous anastomosis ; Supermicrosurgery ; Lymphoedema therapy ; Head-and-neck reconstruction ; ICG ; Intra-operative lymphography
• 刊名：Journal of Plastic, Reconstructive Aesthetic Surgery
• 出版年：2011
• 出版时间：September 2011
• 年：2011
• 卷：64
• 期：9
• 页码：1221-1225
• 全文大小：1658 K

文摘

Summary

Lymphaticovenous anastomosis (LVA) is a treatment for lymphoedema that can improve lymph circulation by the anastomosis of lymph vessels and veins. A therapeutic effect of LVA for lymphoedema has been shown in limbs, but efficacy for other regions has not been shown. Lymphoedema in the head-and-neck region following cancer resection and radiotherapy is mainly treated with manual lymphatic drainage. However, there is no alternative when this treatment is ineffective because application of compression treatment using a bandage is difficult in this region. We used LVA for lymphoedema in the head-and-neck region and achieved a good outcome. Functional and dilating lymph vessels were identified using pre- and intra-operative fluorescent lymphography, and a lymph vessel with a diameter of about 0.2–1.0 mm was anastomosed with a vein using supermicrosurgery. The outcome of this case suggests that LVA is applicable for treatment of lymphoedema in the head-and-neck region.