Primary intrapelvic lymphaticovenular anastomosis following lymph node dissection.
Lymphedema of lower extremities occurs following surgical resection of malignant tumors and intrapelvic lymph node dissection and is a long-term problem for patients. We performed primary intrapelvic lymphaticovenular anastomosis to prevent postoperative leg lymphedema. The procedures were conducted in 7 patients (aged 35-61 years) with cancer of the uterine body. After completion of hystero-oophorectomy and intrapelvic lymph node dissection, the afferent lymphatics entering internal and external iliac lymph nodes were end-to-end anastomosed with branches of the deep inferior epigastric veins. The time taken for constructing 4 anastomoses was 100 to 120 minutes. The follow-up period ranged from 10 to 18 months (mean, 14 months). All patients were discharged and are independent in daily living. Apart from mild leg lymphedema in 1 patient, no lymphedema was observed in other patients up to the last follow-up. This surgical modality is effective in preventing lymphedema in lower extremities after intrapelvic para-aortic lymph node dissection.
Takeishi
Meisei
M
Department of Plastic and Reconstructive Surgery , Jikei University School of Medicine, Minatoku Tokyo, Japan. takeishi@jikei.ac.jp
Kojima
Masahiro
M
Mori
Katuya
K
Kurihara
Kunihiro
K
Sasaki
Hiroshi
H
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D042601:Lymphatic Vessels / Q000601:surgery*; D008209:Lymphedema / Q000209:etiology* / Q000601:surgery*; D008875:Middle Aged; D014594:Uterine Neoplasms / Q000601:surgery; D014680:Veins / Q000601:surgery*