Effects of Ultrasound-guided Lower Abdominal Lymphaticovenous Anastomosis on Lower Abdominal Lymphedema
Summary:. Lymphedema of the lower extremities can be further complicated by lymphedema of the lower abdomen and genitalia. This study aimed to clarify the effect of lower abdominal lymphaticovenous anastomosis (LVA) on lower abdominal lymphedema. The patient was a 61-year-old woman. At the age of 49...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2023-12-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005443 |
| _version_ | 1827397793032962048 |
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| author | Hisako Hara, MD, PhD Makoto Mihara, MD |
| author_facet | Hisako Hara, MD, PhD Makoto Mihara, MD |
| author_sort | Hisako Hara, MD, PhD |
| collection | DOAJ |
| description | Summary:. Lymphedema of the lower extremities can be further complicated by lymphedema of the lower abdomen and genitalia. This study aimed to clarify the effect of lower abdominal lymphaticovenous anastomosis (LVA) on lower abdominal lymphedema. The patient was a 61-year-old woman. At the age of 49 years, she underwent treatment for ovarian cancer, including pelvic lymphadenectomy, and she developed lymphedema in the lower abdomen and bilateral thigh 2 years later. During lymphoscintigraphy, isotopes injected into the dorsum of the bilateral feet accumulated in the corresponding areas, indicating that lymph flowed into these areas from the legs. Compression therapy was performed with a girdle; however, its effect was limited. According to the lymphoscintigraphic findings, we performed LVA in the bilateral thighs (two anastomoses each), and the edema symptoms slightly improved postoperatively. However, as edema was still present and the patient sought further relief, we evaluated the lymphatic vessels in the lower abdomen using lymphatic ultrasound and found dilated lymphatic vessels. We performed another LVA in the lower abdomen 1 year after the first LVA (two anastomoses in the right abdomen, one anastomosis in the left abdomen, and an additional anastomosis in the bilateral thighs). The patient’s subjective symptoms improved, and ultrasonography showed a reduction in abdominal lymphedema at 7 months follow-up. For lymphedema in the lower abdomen and genital area that does not improve with compression therapy, appropriate examination to evaluate lymphatic flow and lymphatic degeneration is necessary, and LVA in the lower abdomen may be effective. |
| first_indexed | 2024-03-08T19:16:45Z |
| format | Article |
| id | doaj.art-a57c60f62bcc41ea9dced23c53517caa |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-08T19:16:45Z |
| publishDate | 2023-12-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-a57c60f62bcc41ea9dced23c53517caa2023-12-27T06:50:05ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-12-011112e544310.1097/GOX.0000000000005443202312000-00017Effects of Ultrasound-guided Lower Abdominal Lymphaticovenous Anastomosis on Lower Abdominal LymphedemaHisako Hara, MD, PhD0Makoto Mihara, MD1From the * Department of Lymphatic and Reconstructive Surgery, JR Tokyo General Hospital, Tokyo, Japan† Lymphedema Clinic Tokyo, Tokyo, Japan.Summary:. Lymphedema of the lower extremities can be further complicated by lymphedema of the lower abdomen and genitalia. This study aimed to clarify the effect of lower abdominal lymphaticovenous anastomosis (LVA) on lower abdominal lymphedema. The patient was a 61-year-old woman. At the age of 49 years, she underwent treatment for ovarian cancer, including pelvic lymphadenectomy, and she developed lymphedema in the lower abdomen and bilateral thigh 2 years later. During lymphoscintigraphy, isotopes injected into the dorsum of the bilateral feet accumulated in the corresponding areas, indicating that lymph flowed into these areas from the legs. Compression therapy was performed with a girdle; however, its effect was limited. According to the lymphoscintigraphic findings, we performed LVA in the bilateral thighs (two anastomoses each), and the edema symptoms slightly improved postoperatively. However, as edema was still present and the patient sought further relief, we evaluated the lymphatic vessels in the lower abdomen using lymphatic ultrasound and found dilated lymphatic vessels. We performed another LVA in the lower abdomen 1 year after the first LVA (two anastomoses in the right abdomen, one anastomosis in the left abdomen, and an additional anastomosis in the bilateral thighs). The patient’s subjective symptoms improved, and ultrasonography showed a reduction in abdominal lymphedema at 7 months follow-up. For lymphedema in the lower abdomen and genital area that does not improve with compression therapy, appropriate examination to evaluate lymphatic flow and lymphatic degeneration is necessary, and LVA in the lower abdomen may be effective.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005443 |
| spellingShingle | Hisako Hara, MD, PhD Makoto Mihara, MD Effects of Ultrasound-guided Lower Abdominal Lymphaticovenous Anastomosis on Lower Abdominal Lymphedema Plastic and Reconstructive Surgery, Global Open |
| title | Effects of Ultrasound-guided Lower Abdominal Lymphaticovenous Anastomosis on Lower Abdominal Lymphedema |
| title_full | Effects of Ultrasound-guided Lower Abdominal Lymphaticovenous Anastomosis on Lower Abdominal Lymphedema |
| title_fullStr | Effects of Ultrasound-guided Lower Abdominal Lymphaticovenous Anastomosis on Lower Abdominal Lymphedema |
| title_full_unstemmed | Effects of Ultrasound-guided Lower Abdominal Lymphaticovenous Anastomosis on Lower Abdominal Lymphedema |
| title_short | Effects of Ultrasound-guided Lower Abdominal Lymphaticovenous Anastomosis on Lower Abdominal Lymphedema |
| title_sort | effects of ultrasound guided lower abdominal lymphaticovenous anastomosis on lower abdominal lymphedema |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005443 |
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