title: LYMPHA Technique to Prevent Secondary Lower Limb Lymphedema.
abstract: Inguinofemoral lymphadenectomy carries a high risk of lower limb lymphedema. This report describes the feasibility of performing multiple lymphatic-venous anastomoses (MLVA) after inguinofemoral lymph node completion (LYMPHA technique) and the possible benefit of LYMPHA for preventing lymphedema.
  
  
  
  Between February, 2011 and October, 2014, 11 patients with vulvar cancer and 16 patients with melanoma of the trunk requiring inguinofemoral lymphadenectomy underwent lymph node dissection and the LYMPHA technique. Blue dye was injected into the thigh 10 min before surgery. Lymphatics afferent to the blue nodes were used to perform MLVA using a collateral branch of the great saphenous vein.
  
  
  
  The mean age of patients in the vulvar cancer group was 52 years (range, 48-75 years). The melanoma group comprised seven men and nine women with a mean age of 41 years (range, 37-56 years). Of the 16 patients, 5 with vulvar cancer underwent bilateral inguinofemoral lymphadenectomy, whereas the remaining 6 patients with vulvar cancer and all 16 patients with melanoma of the trunk had unilateral node dissection. All the patients were treated by the LYMPHA technique. No lymphocele or infectious complications occurred. Transient lower-extremity edema occurred for one melanoma patient (6.25 %), which resolved after 2 months, and permanent lower-extremity edema occurred for one patient (9 %) with vulvar cancer.
  
  
  
  The LYMPHA technique appears to be feasible, safe, and effective for the prevention of lower limb lymphedema, thereby improving the patient's quality of life and decreasing health care costs.
authors.affiliation: Unit of Lymphatic Surgery, Department of Surgery, IRCCS S. Martino Hospital - IST, National Cancer Institute for Cancer Research, University of Genoa, Genova, Italy. francesco.boccardo@unige.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Boccardo
authors.affiliation: Department of Obstetrics and Gynecology, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Valenzano
authors.affiliation: Department of Obstetrics and Gynecology, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Costantini
authors.affiliation: Department of Obstetrics and Gynecology, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Casabona
authors.affiliation: Department of Obstetrics and Gynecology, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Morotti
authors.affiliation: Department of Obstetrics and Gynecology, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Sala
authors.affiliation: Unit of Oncologic Surgery, Department of Surgery, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: De Cian
authors.affiliation: Unit of Lymphatic Surgery, Department of Surgery, IRCCS S. Martino Hospital - IST, National Cancer Institute for Cancer Research, University of Genoa, Genova, Italy.
authors.forename: Lidia
authors.initials: L
authors.lastname: Molinari
authors.affiliation: Unit of Lymphatic Surgery, Department of Surgery, IRCCS S. Martino Hospital - IST, National Cancer Institute for Cancer Research, University of Genoa, Genova, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Spinaci
authors.affiliation: Unit of Lymphatic Surgery, Department of Surgery, IRCCS S. Martino Hospital - IST, National Cancer Institute for Cancer Research, University of Genoa, Genova, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Dessalvi
authors.affiliation: Unit of Lymphatic Surgery, Department of Surgery, IRCCS S. Martino Hospital - IST, National Cancer Institute for Cancer Research, University of Genoa, Genova, Italy.
authors.forename: Corrado Cesare
authors.initials: CC
authors.lastname: Campisi
authors.affiliation: Unit of Nuclear Medicine, Department of Surgery, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Villa
authors.affiliation: Unit of Lymphatic Surgery, Department of Surgery, IRCCS S. Martino Hospital - IST, National Cancer Institute for Cancer Research, University of Genoa, Genova, Italy.
authors.forename: Corradino
authors.initials: C
authors.lastname: Campisi
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D006801:Humans; D007264:Inguinal Canal; D008197:Lymph Node Excision / Q000009:adverse effects*; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000601:surgery*; D008209:Lymphedema / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008545:Melanoma / Q000556:secondary*; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*; D060726:Torso; D014680:Veins / Q000601:surgery*; D014846:Vulvar Neoplasms / Q000473:pathology*