[A new technic of lymphatico-venous anastomosis for the treatment of lymphedema of the limbs].
The authors introduce a new technique of lymphatic-venous anastomosis in cases of lymphedema of the limbs. The anastomosis is of buried type and is described in detail. The procedure is easy, practical and can be indicated for both the upper and lower limbs, and also for thoracic duct or anyone blocked lymphatic of the abdomen. In all cases, we did lymphangioadenography and phlebography and in some cases arteriography. Our experience consists of 81 patients with 89 operations with 302 anastomoses of lymphatic vessels blocked by some disease or surgical resection of benign tumors or consequent to plastic surgery (abdomen pendulous, resection of lipomas of the inguinal region of the thigh, plastic surgery of the thigh), orthopedic operations on the knee or to the stripping of varicose veins. The purpose of the procedure is to divert the lymph to the vein in cases of blocked lymphatic vessels, particularly when lymphographic findings demonstrate good functional and good permeability of lymphatic vessels. Six operations failed in five patients (in one patient: two operations); the anastomoses failure occurred in the first cases operated on, when we did one or two anastomoses and had not learned some faulty details of technique. An average reduction of 76% of the edema was achieved. The reduction is in proportion to the number of anastomoses. Anastomoses as a routine, whenever possible, must be over five in number. We insist in the number of anastomoses because we must consider that some of them can be lost by thrombosis or by faulty technique.(ABSTRACT TRUNCATED AT 250 WORDS)
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D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008208:Lymphatic System / Q000601:surgery*; D008209:Lymphedema / Q000601:surgery*; D008220:Lymphography; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D010690:Phlebography; D013536:Suture Techniques; D014656:Vascular Surgical Procedures / Q000379:methods; D014680:Veins / Q000601:surgery*
Nouvelle technique d'anastomose lymphatico-veineuses pour le traitement des lymphoedèmes des membres.