title: Net effect of lymphaticovenous anastomosis on volume reduction of peripheral lymphoedema after complex decongestive physiotherapy.
abstract: OBJECTIVE
  The results of reported lymphaticovenous anastomoses include some effects of complex decongestive physiotherapy (CDP). The present study aimed to determine the net effect of lymphaticovenous side-to-end anastomosis (LVSEA) in patients with lower limb lymphoedema treated by preoperative CDP.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  37 LVSEAs in 31 patients.
  
  
  METHODS
  Volumes of the thigh and leg with oedema were compared between the time of initial examination, and before (application of CDP) and after LVSEA. The patients were divided into two groups based on the number of anastomoses and lymphoscintigraphic findings.
  
  
  RESULTS
  Preoperative CDP resulted in a reduction of 593 ml (both leg and thigh; p < 0.001). After CDP, LVSEA (1-8 anastomoses; average of 5) reduced the volume by 109 ml (52 ml for the thigh (p = 0.01) and 57 ml for the leg (p = 0.002)). There was no significant difference in volume reduction on lymphoscintigraphy. Volume was significantly reduced (by 55 ml in the thigh, p = 0.049; 96 ml in the leg, p = 0.006) in the group that underwent 6-8, but not 1-5 LVSEAs.
  
  
  CONCLUSIONS
  The net effect of LVSEA on volume reduction was confirmed, but was not particularly large. The need for CDP decreased in some patients postoperatively, and these patients should be considered for evaluation.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura Kanazawa-ku, Yokohama 236-0004, Japan. maegawaj@med.yokohama-cu.ac.jp
authors.forename: J
authors.initials: J
authors.lastname: Maegawa
authors.forename: M
authors.initials: M
authors.lastname: Hosono
authors.forename: H
authors.initials: H
authors.lastname: Tomoeda
authors.forename: A
authors.initials: A
authors.lastname: Tosaki
authors.forename: S
authors.initials: S
authors.lastname: Kobayashi
authors.forename: T
authors.initials: T
authors.lastname: Iwai
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007866:Leg; D035002:Lower Extremity / Q000098:blood supply*; D042601:Lymphatic Vessels / Q000601:surgery*; D008209:Lymphedema / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D061305:Lymphoscintigraphy; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000628:therapy; D014656:Vascular Surgical Procedures; D014680:Veins / Q000601:surgery*