Effect of lymphatic circulation reconstruction under supermicrosurgery in secondary lymphedema of lower limbs
10.3969/j.issn.1005-6483.20241378
- VernacularTitle:超级显微外科下的淋巴循环重建治疗下肢继发性淋巴水肿的疗效分析
- Author:
Linxuan HAN
1
;
Rongyu LAN
;
Jian MO
;
Weihua ZHANG
;
Xiaofei WU
;
Jie QIN
;
Zhuotan WU
;
Xiaoping REN
;
Guangmei DENG
Author Information
1. 530011 广西南宁,广西中医药大学附属瑞康医院修复重建显微外科
- Publication Type:Journal Article
- Keywords:
lymphedema;
vascularized lymph node flap;
lymphovascular venous anastomosis
- From:
Journal of Clinical Surgery
2025;33(9):997-1002
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the efficacy of vascularized lymph node transplantation(VLNT)combined with lymphatic venous anastomosis(LVA)in the treatment of secondary lower extremity lymphedema assisted by super microsurgical techniques.Methods A retrospective analysis was performed for 15 patients with secondary lower limb lymphedema who underwent VLNT+LVA surgery in the Department of Reconstructive and Reconstructive Microsurgery of Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine from July 2021 to July 2023,and compared the circumference and volume of each segment of the lower limb between the preoperative and postoperative 90 days.LVA according to the results of ICG examination,3-5 parts of the lower limb were selected for"Z"shaped surgery,and the lymphatic vessels and venules were anastomosed under the microscope in the subcutaneous fat layer.VLNT confirmed and labeled the saphenous branch of the descending knee artery and its accompanying veins in the popliteal fossa,and the latissimus dorsi lymph node flap was incised,and the flap vessels were anastomosed with the saphenous branch of the descending knee artery and its accompanying veins.Postoperative observation of flap vascularization.The circumference and volume of the affected limb were measured before surgery and 90 days after surgery.Results A total of 15 patients with lower extremity lymphedema were included without serious complications.Statistical analysis showed that the circumference of all levels of the affected limb and the volume of the affected limb were improved 90 days after operation compared with those before surgery.Among them,the limb circumference and volume at each level from the highest point of the dorsum of the foot to 52 cm above the ankle improved 90 days after the operation compared with those before the operation.Conclusion LNT+LVA treatment for secondary lower extremity lymphedema can effectively control edema and improve the function of the affected limb.
