Treatment of lymphedema with lymphaticovenular anastomoses

被引：92

作者：

Nagase T. ^{[1
]}

Gonda K. ^{[1
]}

Inoue K. ^{[1
]}

Higashino T. ^{[1
]}

Fukuda N. ^{[1
]}

Gorai K. ^{[1
]}

Mihara M. ^{[1
]}

Nakanishi M. ^{[1
]}

Koshima I. ^{[1
]}

机构：

[1] Department of Plastic and Reconstructive Surgery, University of Tokyo, Graduate School of Medicine, Bunkyo-ku, Tokyo 113-8655

来源：

International Journal of Clinical Oncology | 2005年 / 10卷 / 5期

关键词：

Lymphangiogenesis; Lymphaticovenular anastomosis; Lymphedema; Supermicrosurgery;

D O I：

10.1007/s10147-005-0518-5

中图分类号：

学科分类号：

摘要：

Although lymphedema in the extremities is a troublesome adverse effect following radical resection of various cancers, conventional therapies for lymphedema are not always satisfactory, and new breakthroughs are anticipated. With the introduction of supermicrosurgical techniques for the anastomosis of blood or lymphatic vessels less than 0.8 mm in diameter, we have developed a novel method of lymphaticovenular anastomosis for the treatment of primary as well as secondary lymphedema in the extremities. Here, we review the pathophysiological aspects of lymphedema, emphasizing the importance of smooth-muscle cell function in the affected lymphatic walls. We then describe the theoretical basis and detailed operative techniques of our lymphaticovenular anastomoses. Although technically demanding, especially for beginners, we believe that this method will become a new clinical standard for the treatment of lymphedema in the near future. © The Japan Society of Clinical Oncology 2005.

引用

页码：304 / 310

页数：6

共 26 条

[1]

Thompson N., Buried dermal flap operation for chronic lymphedema of the extremities. Ten-year survey of results in 79 cases, Plast Reconstr Surg, 45, pp. 541-548, (1970)

[2]

Koshima I., Nanba Y., Tsutsui T., Et al., Medial plantar perforator flaps with supermicrosurgery, Clin Plast Surg, 30, pp. 447-455, (2003)

[3]

Koshima I., Inagawa K., Etoh K., Et al., Supramicrosurgical lymphaticovenular anastomosis for the treatment of lymphedema in the extremities (in Japanese), Nippon Geka Gakkai Zasshi (Journal of Japan Surgical Society), 100, pp. 551-556, (1999)

[4]

Koshima I., Inagawa K., Urushibara K., Et al., Supermicrosurgical lymphaticovenular anastomosis for the treatment of lymphedema in the upper extremities, J Reconstr Miscrosurg, 16, pp. 437-442, (2000)

[5]

Koshima I., Nanba Y., Tsutsui T., Et al., Long-term follow-up after lymphaticovenular anastomosis for lymphedema in the leg, J Reconstr Microsurg, 19, pp. 209-215, (2003)

[6]

Koshima I., Nanba Y., Tsutsui T., Et al., Minimal invasive lymphaticovenular anastomosis under local anesthesia for leg lymphedema: Is it effective for stage III and IV?, Ann Plast Surg, 53, pp. 261-266, (2004)

[7]

Koshima I., Higashino T., Fukuda N., Et al., Functional and structural characteristics of lymphatic systems and lymphedema (in Japanese), Ensho to Men-eki (Inflammatology and Immunology), 13, pp. 426-431, (2005)

[8]

Oliver G., Lymphatic vasculature development, Nat Rev Immunol, 4, pp. 35-45, (2004)

[9]

Karkkainen M.J., Saaristo A., Jussila L., Et al., A model for gene therapy of human hereditary lymphedema, Proc Natl Acad Sci U S a, 98, pp. 12677-12682, (2001)

[10]

Ferrell R.E., Research perspectives in inherited lymphatic disease, Ann N Y Acad Sci, 979, pp. 39-51, (2002)

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