Minimal invasive lymphaticovenular anastomosis under local anesthesia for leg lymphedema: is it effective for stage III and IV?
This is the first report on the effectiveness of minimal invasive lymphaticovenular anastomosis under local anesthesia for leg lymphedema. Fifty-two patients (age: 15 to 78 years old; 8 males, 44 females) were treated with lymphaticovenular anastomoses under local anesthesia and by postoperative compression using elastic stockings. The average duration of edema of these patients before treatment was 5.3 +/- 5.0 years. The average number of anastomosis in each patient was 2.1 +/- 1.2 (1-5). The patients were followed for an average of 14.5 +/- 10.2 months, and the result were considered effective (82.5%) even for the patients with stage III (progressive edema with acute lymphangitis) and IV (fibrolymphedema), but others showed no improvement. Among these cases, 17 patients showed reduction of over 4 cm in the circumference of the lower leg. The average decrease in the circumference excluding edema in bilateral legs was 41.8 +/- 31.2% of the preoperative excess length. These results indicate that minimal invasive lymphaticovenular anastomosis under a local anesthesia is valuable instead of general anesthesia.
Koshima
Isao
I
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine and Dentistry, Okayama University, Okayama, Japan. plakoshi@cc.okayama-u.ac.jp
Nanba
Yuzaburo
Y
Tsutsui
Tetsuya
T
Takahashi
Yoshio
Y
Itoh
Seiko
S
Fujitsu
Misako
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D000772:Anesthesia, Local; D005260:Female; D006801:Humans; D007866:Leg; D008205:Lymphangitis / Q000150:complications / Q000601:surgery; D008209:Lymphedema / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016896:Treatment Outcome