title: Multisite Lymphaticovenular Anastomosis Using Vein Graft for Uterine Cancer-Related Lymphedema After Pelvic Lymphadenectomy.
abstract: BACKGROUND
  Lymphaticovenular anastomosis (LVA) is becoming a treatment option for lymphedema. It is challenging to perform LVA when a lymphatic vessel is too far from a vein to anastomose directly.
  
  
  METHODS
  We applied vein grafting for simultaneous multisite LVA (SM-LVA), when there was a considerable distance between a lymphatic vessel and a vein. Five patients with lower extremity lymphedema (LEL) who underwent SM-LVA were included in this study. Feasibility and treatment effect of the method were evaluated.
  
  
  RESULTS
  Simultaneous multisite LVA resulted in 35 anastomoses. Vein grafting was performed in 5 of 35 anastomoses with 100% technical success. All LVAs showed good intraoperative anastomosis patency. At 6 months postoperatively, LEL index was significantly lower than preoperative LEL index (251.0 ± 33.0 vs 271.0 ± 38.5, P < .001).
  
  
  CONCLUSIONS
  In SM-LVA surgery, a vein can be harvested from another surgical field without additional invasiveness and is useful for bridging a lymphatic vessel and a distant vein.
authors.affiliation: Department of Plastic and Reconstructive Surgery, the University of Tokyo, Bunkyo-ku, Tokyo, Japan tyamamoto-tky@umin.ac.jp.
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Plastic and Reconstructive Surgery, the University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Yoshimatsu
authors.affiliation: Department of Plastic and Reconstructive Surgery, the University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Nana
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: Department of Plastic and Reconstructive Surgery, the University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Yokoyama
authors.affiliation: Department of Plastic and Reconstructive Surgery, the University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Numahata
authors.affiliation: Department of Plastic and Reconstructive Surgery, the University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008197:Lymph Node Excision / Q000009:adverse effects*; D042601:Lymphatic Vessels / Q000503:physiopathology / Q000601:surgery*; D008209:Lymphedema / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008220:Lymphography / Q000379:methods; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*; D014654:Vascular Patency; D014680:Veins / Q000503:physiopathology / Q000637:transplantation*
chemical_list: D007208:Indocyanine Green
keywords: indocyanine green; interposition; lymphaticovenular anastomosis; lymphedema; supermicrosurgery; vein graft