Combined Lymphovenous Anastomosis and Great Saphenous Vein Stripping for Comorbid Lymphedema and Varicose Veins.

Treatment for patients with comorbid lymphedema and varicose veins is controversial. Surgical options for these patients are limited. The study was aimed to investigate the validity of combined lymphovenous anastomosis (LVA) and great saphenous vein stripping (GSVS) for comorbid lymphedema and varicose veins.

Modified intraoperative distal compression method for lymphaticovenous anastomosis with high success and a low venous reflux rates.

Introduction: For successful lymphaticovenous anastomosis (LVA), it is important to create anastomoses with high flow to maintain patency. To ensure that this can be achieved, we compared the efficacy of a modified intraoperative distal compression (IDC) technique with the conventional no compression (NC) method for lower limb lymphedema.

Patients And Methods: In the IDC group, compression was applied to an area of the foot distal to the first LVA site.

Lymphovenous Anastomosis for Morbidly Obese Patients with Lymphedema.

Unlabelled: Although patients with obesity-induced lymphedema can be treated by weight loss therapy, they find it difficult to lose the required amount of weight. The aims of this study were to clarify the characteristics of the lymphatic vessels in patients with obesity-induced lymphedema and to determine the feasibility and efficacy of lymphovenous anastomosis (LVA) in these patients.

Methods: Twenty-two patients (44 edematous lower limbs) with a body mass index (BMI) >35 kg/m (obese group) and 91 patients with lymphedema (141 edematous lower limbs) and BMI <25 kg/m were enrolled as a control group (nonobese group) and underwent LVA.

Microscope-Induced Thermal Burns During Lymphaticovenular Anastomosis.

Bright illumination sources using xenon lamps have improved microsurgical visualization under an operating microscope; however, surgeons must recognize the potential for accidental thermal damage to soft tissues.In this article, we present 2 reports of microscopic thermal burn in lymphaticovenular anastomosis (LVA).A 23-year-old woman and a 57-year-old woman with bilateral lymphedema of the legs had LVAs on both legs under local anesthesia.

Characteristics and outcomes of lymphaticovenular anastomosis in older patients with bilateral involvement versus younger patients with unilateral involvement in lower extremity lymphedema.

Objective: We have previously reported that patients with idiopathic primary lymphedema of adult onset can be classified into an older group with bilateral involvement and a younger group with unilateral involvement and that there are significant differences in the characteristics of these groups. The aims of this study were to investigate the features of these two groups further by evaluating the lymphatics while performing lymphaticovenular anastomosis (LVA) and to compare the effectiveness of LVA between the two groups.

Methods: This study enrolled 74 patients (136 edematous legs) in whom indocyanine green (ICG) lymphography and LVA were performed.

Lymphovenous Anastomosis Aids Wound Healing in Lymphedema: Relationship Between Lymphedema and Delayed Wound Healing from a View of Immune Mechanisms.

Delayed wound healing in lymphedema is assumed to be caused by two reasons, pathophysiological and immunological effects of lymphedema. The aim of this review is to establish how impaired lymphatics alter wound healing pathophysiologically and immunologically, and to propose treatment modalities that can promote wound healing in lymphedema. Lymphaticovenular anastomoses (lymphovenous anastomoses [LVAs]) were performed on patients who had recurrent cellulitis several times with lymphorrhea and developed severe ulcers that were refractory to skin grafts, flaps, and conservative therapy.

Localized lymphedema after treatment for soft tissue sarcoma in the lower limbs: Comparison of improvement according to duration before lymphaticovenular anastomosis.

Surgically invasive procedures involving the medial knee and inguinal regions can cause lymphedema. Lymphaticovenular anastomosis (LVA) could improve volume reduction and decrease the risk of cellulitis. However, it may be preferable to performed LVA as early as possible to achieve optimal results.

Lymphaticovenular anastomosis and venous arterialization in coexisting Raynaud's phenomenon and lymphedema: A case report.

Raynaud's phenomenon is highly prevalent in the general population. The optimal medical management for patients with severe Raynaud's phenomenon remains unclear. Venous arterialization (VA) may be considered as a salvage procedure when no distal vessels are available for vascular reconstruction.

Indocyanine green lymphography findings in older patients with lower limb lymphedema.

Objective: Lymphedema is classified as primary or secondary according to the underlying cause. Primary lymphedema is hereditary and is considered a consequence of an inherited abnormality of the lymphatic system. Secondary lymphedema, however, is a consequence of lymphatic failure resulting from trauma, parasitic infection, or iatrogenic obstruction.

Lymphatic flow restoration after stripping surgery for varicose veins: A case report.

It has been suggested that the dynamics of the venous and lymphatic systems interact as a mutually dependent dual outflow system and that derangement of lymph flow could be reversed by surgical treatment of venous incompetence. In this report, we describe a patient in whom lymphatic function was restored after stripping of the great saphenous vein for varicosity. The patient was a 79-year-old woman who had varicose veins along the medial side of an edematous left leg.

Line production system for multiple lymphaticovenular anastomoses.

Background: A drawback of multiple lymphaticovenular anastomoses (LVAs) is the need for at least two microsurgeons and the same number of microscopes. In practice, many hospitals find it difficult to access such resources. We have developed a novel line production system (LPS) to address this problem.

Mechanical Dilation Using Nylon Monofilament Aids Multisite Lymphaticovenous Anastomosis Through Improving the Quality of Anastomosis.

Lymphaticovenous anastomosis (LVA) is now a common treatment for lymphedema. It is important to create as many bypasses as possible to maximize the efficacy of LVA. We have developed a method whereby nylon monofilaments are placed inside the vessel lumen to act as dilators.

Mechanical Dilation With a Nylon Monofilament for 0.1-mm Anastomoses.

Despite advances in supermicrosurgical techniques, the ability to anastomose vessels with a diameter of less than 0.2 mm remains limited. One of the reasons for this limitation is that the dilation methods currently available, such as inserting the tip of a microforceps into the lumen or topical application of a vasodilator such as papaverine hydrochloride or xylocaine spray, are not effective in very small vessels.