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Preventing Breast Cancer-Related Lymphedema: A Comprehensive Analysis of a 9-Year Single-Center Experience of Prophylactic Lymphovenous Bypass.
Ann Surg Oncol
December 2024
Department of Plastic and Reconstructive Surgery, The Ohio State University, Columbus, OH, USA.
Background: Prophylactic lymphovenous bypass (pLVB) is a microsurgical technique aimed to prevent breast cancer-related lymphedema (BCRL) after axillary lymph node dissection (ALND) by redirecting lymphatic flow from the ligated lymphatics into neighboring veins. This report describes the authors' 9-year institutional experience of pLVB in patients undergoing ALND to prevent BCRL.
Methods: Patients who underwent ALND were reviewed.
Staging Approaches to Lymphatic Surgery: Techniques and Considerations.
J Surg Oncol
November 2024
Division of Plastic and Reconstructive Surgery, Cedars Sinai Medical Center, Los Angeles, California, USA.
Lymphatic surgery has demonstrated promising outcomes for the treatment of lymphedema alongside nonsurgical techniques. Physiologic lymphatic surgeries including lymphovenous bypass and vascularized lymph node transplants address the fluid burden in lymphedema whereas reductive surgeries including suction lipectomy and excisional techniques address the fibroadipose component of the disease. Lymphedema patients often present with both fluid and fat components that may require different procedures for optimal results.
View Article and Find Full Text PDFLymphatic Imaging and Intervention in Congenital Heart Disease.
J Soc Cardiovasc Angiogr Interv
January 2024
Department of Cardiology, Jill and Mark Fishman Center for Lymphatic Disorders, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
The lymphatic system plays a central role in some of the most devastating complications associated with congenital heart defects. Diseases like protein-losing enteropathy, plastic bronchitis, postoperative chylothorax, and chylous ascites are now proven to be lymphatic in origin. Novel imaging modalities, most notably, noncontrast magnetic resonance lymphangiography and dynamic contrast-enhanced magnetic resonance lymphangiography, can now depict lymphatic anatomy and function in all major lymphatic compartments and are essential for modern therapy planning.
View Article and Find Full Text PDFThe Possible Role of Lymphaticovenous and Lymph Node to Vein Anastomosis for Improvement of Milroy Disease Related Congenital Chylothorax and Lower Extremity Lymphedema.
Plast Reconstr Surg
July 2024
Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center, Seoul, Korea.
Introduction: Primary lymphedema is characterized by lymphatic dysplasia in which one variant is Milroy's disease. The association with congenital chylothorax is even rarer with poor outcome. This is the first report to utilize peripheral lymphovenous anastomosis (LVA) and lymph node to vein anastomosis (LNVA) for the management of such condition.
View Article and Find Full Text PDFPreliminary report of a thoracic duct-to-pulmonary vein lymphovenous anastomosis in swine: A novel technique and potential treatment for lymphatic failure.
Semin Pediatr Surg
June 2024
Division of Cardiovascular Surgery, Department of Surgery, The University of Pennsylvania, Philadelphia, PA, United States; Division of Cardiothoracic Surgery, Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Jill and Mark Fishman Center for Lymphatic Disorders, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
Objective: The thoracic duct is the largest lymphatic vessel in the body, and carries fluid and nutrients absorbed in abdominal organs to the central venous circulation. Thoracic duct obstruction can cause significant failure of the lymphatic circulation (i.e.
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