Effectiveness of Supramicrosurgical Lymphatico-venular Anastomosis in Treating Recurrent Lymphatic Fistulas: A Case Series
Objective: Lymphatic fistula is a complication that may occur in all cases where lymphostasis arise, due to a damage to the lymphatic drainage system. The current study evaluates the effectiveness of supramicrosurgical lymphatico-venular anastomosis (s-LVA) for treating lymphatic fistula. Patients a...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Japan Society of Plastic and Reconstructive Surgery
2023-10-01
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| Series: | Journal of Plastic and Reconstructive Surgery |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/jprs/2/4/2_2022-0028/_pdf/-char/en |
| _version_ | 1797643480318607360 |
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| author | Paolo Gennaro Glauco Chisci Flavia Cascino Michael Aboud Gasser Guido Gabriele |
| author_facet | Paolo Gennaro Glauco Chisci Flavia Cascino Michael Aboud Gasser Guido Gabriele |
| author_sort | Paolo Gennaro |
| collection | DOAJ |
| description | Objective: Lymphatic fistula is a complication that may occur in all cases where lymphostasis arise, due to a damage to the lymphatic drainage system. The current study evaluates the effectiveness of supramicrosurgical lymphatico-venular anastomosis (s-LVA) for treating lymphatic fistula.
Patients and Methods: This is a retrospective study that aims to evaluate the effectiveness of s-LVA in treating lymphatic fistula. The inclusion criterion was the presence of persistent chronic lymphatic fistula; the exclusion criteria were refuse of the patient, terminal patients.
All patients presented with lymphatic fistula. To evaluate lymphatic patency, indocyanine green (ICG) lymphography was performed in preoperative, immediately afterward and 1 month after s-LVA. Postoperative follow-up was performed for 1 year. The site for skin incision was selected on the basis of the ICG lymphography and the venous mapping. s-LVA was performed with 11-0 sutures using an operating microscope. Afterward, the skin incision was sutured with 6-0 absorbable sutures.
Results: Eight patients (five males and three females) were enrolled in this study. Lymphatic vessels identified during s-LVA resulted ectasic. ICG lymphography demostrated patency of the anastomosis in all patients since the first postoperative day except one case, where the anastomosis resulted patent 1 month after s-LVA. No clinical complications were reported during the postoperative follow-up: no cellulitis and no recurrence of the fistula occurred in the year after s-LVA. Total recovery of fistula was observed and confirmed for the year after the intervention.
Conclusions: This study evidenced positive results with lymphorrhea interruption and recovery of the fistula after the intervention. |
| first_indexed | 2024-03-11T14:16:27Z |
| format | Article |
| id | doaj.art-a79b4e850a6444059e9a92c16d3c7f8a |
| institution | Directory Open Access Journal |
| issn | 2436-259X |
| language | English |
| last_indexed | 2024-03-11T14:16:27Z |
| publishDate | 2023-10-01 |
| publisher | Japan Society of Plastic and Reconstructive Surgery |
| record_format | Article |
| series | Journal of Plastic and Reconstructive Surgery |
| spelling | doaj.art-a79b4e850a6444059e9a92c16d3c7f8a2023-11-01T06:28:48ZengJapan Society of Plastic and Reconstructive SurgeryJournal of Plastic and Reconstructive Surgery2436-259X2023-10-01241631712022-0028Effectiveness of Supramicrosurgical Lymphatico-venular Anastomosis in Treating Recurrent Lymphatic Fistulas: A Case SeriesPaolo Gennaro0Glauco Chisci1Flavia Cascino2Michael Aboud Gasser3Guido Gabriele4Department of Maxillo-Facial Surgery, Faculty of Medicine and Surgery, University of SienaDepartment of Maxillo-Facial Surgery, Faculty of Medicine and Surgery, University of SienaDepartment of Maxillo-Facial Surgery, Policlinico Le ScotteDepartment of Maxillo-Facial Surgery, Faculty of Medicine and Surgery, University of SienaDepartment of Maxillo-Facial Surgery, Faculty of Medicine and Surgery, University of SienaObjective: Lymphatic fistula is a complication that may occur in all cases where lymphostasis arise, due to a damage to the lymphatic drainage system. The current study evaluates the effectiveness of supramicrosurgical lymphatico-venular anastomosis (s-LVA) for treating lymphatic fistula. Patients and Methods: This is a retrospective study that aims to evaluate the effectiveness of s-LVA in treating lymphatic fistula. The inclusion criterion was the presence of persistent chronic lymphatic fistula; the exclusion criteria were refuse of the patient, terminal patients. All patients presented with lymphatic fistula. To evaluate lymphatic patency, indocyanine green (ICG) lymphography was performed in preoperative, immediately afterward and 1 month after s-LVA. Postoperative follow-up was performed for 1 year. The site for skin incision was selected on the basis of the ICG lymphography and the venous mapping. s-LVA was performed with 11-0 sutures using an operating microscope. Afterward, the skin incision was sutured with 6-0 absorbable sutures. Results: Eight patients (five males and three females) were enrolled in this study. Lymphatic vessels identified during s-LVA resulted ectasic. ICG lymphography demostrated patency of the anastomosis in all patients since the first postoperative day except one case, where the anastomosis resulted patent 1 month after s-LVA. No clinical complications were reported during the postoperative follow-up: no cellulitis and no recurrence of the fistula occurred in the year after s-LVA. Total recovery of fistula was observed and confirmed for the year after the intervention. Conclusions: This study evidenced positive results with lymphorrhea interruption and recovery of the fistula after the intervention.https://www.jstage.jst.go.jp/article/jprs/2/4/2_2022-0028/_pdf/-char/enlymphatic fistulalymphedemasupramicrosurgerys-lva |
| spellingShingle | Paolo Gennaro Glauco Chisci Flavia Cascino Michael Aboud Gasser Guido Gabriele Effectiveness of Supramicrosurgical Lymphatico-venular Anastomosis in Treating Recurrent Lymphatic Fistulas: A Case Series Journal of Plastic and Reconstructive Surgery lymphatic fistula lymphedema supramicrosurgery s-lva |
| title | Effectiveness of Supramicrosurgical Lymphatico-venular Anastomosis in Treating Recurrent Lymphatic Fistulas: A Case Series |
| title_full | Effectiveness of Supramicrosurgical Lymphatico-venular Anastomosis in Treating Recurrent Lymphatic Fistulas: A Case Series |
| title_fullStr | Effectiveness of Supramicrosurgical Lymphatico-venular Anastomosis in Treating Recurrent Lymphatic Fistulas: A Case Series |
| title_full_unstemmed | Effectiveness of Supramicrosurgical Lymphatico-venular Anastomosis in Treating Recurrent Lymphatic Fistulas: A Case Series |
| title_short | Effectiveness of Supramicrosurgical Lymphatico-venular Anastomosis in Treating Recurrent Lymphatic Fistulas: A Case Series |
| title_sort | effectiveness of supramicrosurgical lymphatico venular anastomosis in treating recurrent lymphatic fistulas a case series |
| topic | lymphatic fistula lymphedema supramicrosurgery s-lva |
| url | https://www.jstage.jst.go.jp/article/jprs/2/4/2_2022-0028/_pdf/-char/en |
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