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Lymph Node to Vein Anastomosis (LNVA) for lower extremity lymphedema

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Abstract
Abstract
The microsurgical options for lower limb lymphedema is a challenge. In search to improve the overall result, we hypothesized it would be beneficial to add the functioning lymph nodes to vein anastomosis (LNVA) in addition to lymphovenous anastomosis (LVA). This is a retrospective study of 160 unilateral stage II & III lower extremity lymphedema comparing the outcome between the LNVA + LVA group and the LVA only group from May 2013 to June 2018. MRI was used to identify the functioning lymph nodes. Patient outcome, including lower extremity circumference, body weight, bio impedance test, and other data were analyzed to evaluate whether lymph nodes to vein anastomosis (LNVA) improved outcome. The LNVA + LVA group showed significantly better results for circumference reduction rate, body weight reduction rate, and extracellular fluid reduction rate of the affected limb as compared to the LVA only group for both stage II and III lymphedema. The MRI imaging revealed that 9 cases had no identifiable lymph nodes of the affected limb and 54 cases with a nonfunctioning lymph node upon exploration despite positive imaging. Correlation showed the lymph node size needed to be at least 8 mm in the MRI to be functional. The LNVA + LVA approach for lymphedema has the benefit of better reduction as compared to LVA alone in the lower limb as well as the suprapubic region. Preoperative MRI will help to identify the functioning lymph node by increasing the overall probability of positive outcome.
Author(s)
권진근박창식서현석조민정홍준표
Issued Date
2021
Type
Article
Keyword
Body weightLymph node to vein anastomosisLymphedemaLymphovenous anastomosisMedical collegesSupermicrosurgerySurgeryPlastic
DOI
10.1016/j.bjps.2021.01.005
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7568
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2494875603&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Lymph%20Node%20to%20Vein%20Anastomosis%20(LNVA)%20for%20lower%20extremity%20lymphedema&offset=0&pcAvailability=true
Publisher
Journal of Plastic Reconstructive and Aesthetic Surgery
Location
네덜란드
Language
영어
ISSN
1748-6815
Citation Volume
74
Citation Number
9
Citation Start Page
2059
Citation End Page
2067
Appears in Collections:
Medicine > Medicine
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