Preliminary observation of deep cervical lymphatic-venous anastomosis under off-eyepiece 3D microscope to treat an elderly patient with cognitive impairment
10.3760/cma.j.cn441206-20210809-00194
- VernacularTitle:3D脱目镜下行颈深淋巴管-静脉引流术治疗老年认知障碍患者一例疗效初步观察
- Author:
Hongrui LU
1
;
Yunfei TAN
;
Qingping XIE
Author Information
1. 浙江省人民医院，杭州医学院附属人民医院整形外科中心，手外科和修复重建外科，杭州 310014
- Keywords:
Cognitive impairment;
Deep cervical lymphatic-venous anastomosis;
3D visualization technique of without eyepiece with microscope;
Lymphatic fluorescence
- From:
Chinese Journal of Microsurgery
2022;45(5):570-574
- CountryChina
- Language:Chinese
-
Abstract:
In September 2020, an elderly patient with cognitive impairment(CI) was admitted in Deparment of Microsurgery, Hangzhou Qiushi Hospital. The patient was in bed and could not answer correctly before surgery. The preoperative Minimum Mental State Examination(MMSE) score was 3(3/30) and the Montreal Cognitive Assessment (MoCA) score was 2(2/30). After completion of preoperative examinations, a 3D microscope combined with fluorescence tracing technique was used to perform deep cervical lymphatic-venous anastomosis at the bilateral cervical Va lymph nodes part: two anastomosis methods were performed, one was end to side anastomosis and the other was end to end anastomosis. The diameters of all anastomotic dilated lymphatic vessels were less than 0.2 mm, the diameters of end-to-side, end to end anastomotic veins were 0.6 mm and 0.2 mm. Short-term postoperative anti-inflammatory treatment was given and a long-term functional rehabilitation training was performed. There were no postoperative complications and the incision healed well. The MMSE scores were 8, 12, 14, 18 point, and the MoCA scores were 8, 9, 11, 13 point. At 3, 30, 90, 180 days after surgery, respectively. Basic cognitive function was restored at 9 months after surgery.
