Microsurgical Lymphovenous Anastomosis for Pelvic Lymphoceles after Gynecological Cancer Surgery
Pelvic lymphoceles are the most common complications after pelvic lymphadenectomy. Microsurgical procedures have attracted attention as an alternative treatment for lymphoceles. Here, we report six cases of refractory lymphoceles that were successfully treated using lymphovenous anastomosis (LVA). S...
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| Veröffentlicht in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2022-03, Vol.75 (3), p.1142-1149 |
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| container_title | Journal of plastic, reconstructive & aesthetic surgery |
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| creator | Yamashita, Shuji Kitamura, Yutaro Fujisawa, Kou Mito, Daisuke Tomioka, Yoko Kurita, Masakazu Miyamoto, Shimpei Iida, Takuya Okazaki, Mutsumi |
| description | Pelvic lymphoceles are the most common complications after pelvic lymphadenectomy. Microsurgical procedures have attracted attention as an alternative treatment for lymphoceles. Here, we report six cases of refractory lymphoceles that were successfully treated using lymphovenous anastomosis (LVA).
Six patients underwent surgery for gynecological cancers and developed pelvic lymphoceles, which did not respond to conventional treatment. We mainly performed LVA on the ipsilateral lower limbs, although some procedures were also performed on the contralateral limbs. The change in the lymphocele volume after LVA was examined using computed tomography and compared using the Wilcoxon test.
Five of the six refractory lymphocele cases were successfully treated using LVA, and the remaining case exhibited an 87% reduction in lymphocele volume. The average numbers of anastomoses were 6.7 on the ipsilateral side and 2.8 on the contralateral side (the median numbers: 6 [range: 5–9] vs. 3 [range: 1–4], P = 0.034). The average lymphocele volume decreased significantly from 414.0 mL preoperatively to 8.0 mL postoperatively (the median lymphocele volume: 255.8 [range: 61.5–1,329.2] vs. 0 [range: 0–47.7], P = 0.0313).
We found that microsurgical treatment was potentially effective for lymphoceles that did not respond to conventional treatment. |
| doi_str_mv | 10.1016/j.bjps.2021.09.056 |
| format | Article |
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Six patients underwent surgery for gynecological cancers and developed pelvic lymphoceles, which did not respond to conventional treatment. We mainly performed LVA on the ipsilateral lower limbs, although some procedures were also performed on the contralateral limbs. The change in the lymphocele volume after LVA was examined using computed tomography and compared using the Wilcoxon test.
Five of the six refractory lymphocele cases were successfully treated using LVA, and the remaining case exhibited an 87% reduction in lymphocele volume. The average numbers of anastomoses were 6.7 on the ipsilateral side and 2.8 on the contralateral side (the median numbers: 6 [range: 5–9] vs. 3 [range: 1–4], P = 0.034). The average lymphocele volume decreased significantly from 414.0 mL preoperatively to 8.0 mL postoperatively (the median lymphocele volume: 255.8 [range: 61.5–1,329.2] vs. 0 [range: 0–47.7], P = 0.0313).
We found that microsurgical treatment was potentially effective for lymphoceles that did not respond to conventional treatment.</description><identifier>ISSN: 1748-6815</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2021.09.056</identifier><identifier>PMID: 34840117</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Anastomosis, Surgical ; Female ; Gynecologic Surgical Procedures - adverse effects ; Humans ; Lymph Node Excision - adverse effects ; Lymph Node Excision - methods ; Lymphedema ; Lymphocele - etiology ; Lymphocele - surgery ; Lymphovenous anastomosis ; Microsurgery ; Neoplasms - surgery ; Pelvic lymphocele ; Pelvis - surgery</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2022-03, Vol.75 (3), p.1142-1149</ispartof><rights>2021 Elsevier Ltd</rights><rights>Copyright © 2021 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c281t-7111e8709070babde63b42c0c6e6f96f76544db2f8c3eae730012852fc4d85d03</cites><orcidid>0000-0003-3601-7739 ; 0000-0003-4046-6713 ; 0000-0001-7626-9565 ; 0000-0003-4367-6927</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1748681521004976$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34840117$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yamashita, Shuji</creatorcontrib><creatorcontrib>Kitamura, Yutaro</creatorcontrib><creatorcontrib>Fujisawa, Kou</creatorcontrib><creatorcontrib>Mito, Daisuke</creatorcontrib><creatorcontrib>Tomioka, Yoko</creatorcontrib><creatorcontrib>Kurita, Masakazu</creatorcontrib><creatorcontrib>Miyamoto, Shimpei</creatorcontrib><creatorcontrib>Iida, Takuya</creatorcontrib><creatorcontrib>Okazaki, Mutsumi</creatorcontrib><title>Microsurgical Lymphovenous Anastomosis for Pelvic Lymphoceles after Gynecological Cancer Surgery</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><addtitle>J Plast Reconstr Aesthet Surg</addtitle><description>Pelvic lymphoceles are the most common complications after pelvic lymphadenectomy. Microsurgical procedures have attracted attention as an alternative treatment for lymphoceles. Here, we report six cases of refractory lymphoceles that were successfully treated using lymphovenous anastomosis (LVA).
Six patients underwent surgery for gynecological cancers and developed pelvic lymphoceles, which did not respond to conventional treatment. We mainly performed LVA on the ipsilateral lower limbs, although some procedures were also performed on the contralateral limbs. The change in the lymphocele volume after LVA was examined using computed tomography and compared using the Wilcoxon test.
Five of the six refractory lymphocele cases were successfully treated using LVA, and the remaining case exhibited an 87% reduction in lymphocele volume. The average numbers of anastomoses were 6.7 on the ipsilateral side and 2.8 on the contralateral side (the median numbers: 6 [range: 5–9] vs. 3 [range: 1–4], P = 0.034). The average lymphocele volume decreased significantly from 414.0 mL preoperatively to 8.0 mL postoperatively (the median lymphocele volume: 255.8 [range: 61.5–1,329.2] vs. 0 [range: 0–47.7], P = 0.0313).
We found that microsurgical treatment was potentially effective for lymphoceles that did not respond to conventional treatment.</description><subject>Anastomosis, Surgical</subject><subject>Female</subject><subject>Gynecologic Surgical Procedures - adverse effects</subject><subject>Humans</subject><subject>Lymph Node Excision - adverse effects</subject><subject>Lymph Node Excision - methods</subject><subject>Lymphedema</subject><subject>Lymphocele - etiology</subject><subject>Lymphocele - surgery</subject><subject>Lymphovenous anastomosis</subject><subject>Microsurgery</subject><subject>Neoplasms - surgery</subject><subject>Pelvic lymphocele</subject><subject>Pelvis - surgery</subject><issn>1748-6815</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAQhoMofqz-AQ_So5fWSZqmKXiRxS9YUVDPMU2nmqVt1qS7sP_eLLt69JQhPPMy70PIOYWMAhVX86yeL0LGgNEMqgwKsUeOqSxlCkVe7ce55DIVkhZH5CSEOQDPKS8OyVHOJQdKy2Py8WSNd2HpP63RXTJb94svt8LBLUNyM-gwut4FG5LW-eQFu5U1O8ZghyHR7Yg-uV8PaFznthlTPZj4-Roz0a9PyUGru4Bnu3dC3u9u36YP6ez5_nF6M0sNk3RMS0opyhIqKKHWdYMirzkzYASKthJtKQrOm5q10uSoscwBKJMFaw1vZNFAPiGX29yFd99LDKPqbYhHdnrAWEYxAZyLnBcyomyLbpoHj61aeNtrv1YU1MasmquNWbUxq6BS0WxcutjlL-sem7-VX5URuN4CGFuuLHoVjMWoorEezagaZ__L_wHA_ouL</recordid><startdate>202203</startdate><enddate>202203</enddate><creator>Yamashita, Shuji</creator><creator>Kitamura, Yutaro</creator><creator>Fujisawa, Kou</creator><creator>Mito, Daisuke</creator><creator>Tomioka, Yoko</creator><creator>Kurita, Masakazu</creator><creator>Miyamoto, Shimpei</creator><creator>Iida, Takuya</creator><creator>Okazaki, Mutsumi</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3601-7739</orcidid><orcidid>https://orcid.org/0000-0003-4046-6713</orcidid><orcidid>https://orcid.org/0000-0001-7626-9565</orcidid><orcidid>https://orcid.org/0000-0003-4367-6927</orcidid></search><sort><creationdate>202203</creationdate><title>Microsurgical Lymphovenous Anastomosis for Pelvic Lymphoceles after Gynecological Cancer Surgery</title><author>Yamashita, Shuji ; Kitamura, Yutaro ; Fujisawa, Kou ; Mito, Daisuke ; Tomioka, Yoko ; Kurita, Masakazu ; Miyamoto, Shimpei ; Iida, Takuya ; Okazaki, Mutsumi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c281t-7111e8709070babde63b42c0c6e6f96f76544db2f8c3eae730012852fc4d85d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Anastomosis, Surgical</topic><topic>Female</topic><topic>Gynecologic Surgical Procedures - adverse effects</topic><topic>Humans</topic><topic>Lymph Node Excision - adverse effects</topic><topic>Lymph Node Excision - methods</topic><topic>Lymphedema</topic><topic>Lymphocele - etiology</topic><topic>Lymphocele - surgery</topic><topic>Lymphovenous anastomosis</topic><topic>Microsurgery</topic><topic>Neoplasms - surgery</topic><topic>Pelvic lymphocele</topic><topic>Pelvis - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yamashita, Shuji</creatorcontrib><creatorcontrib>Kitamura, Yutaro</creatorcontrib><creatorcontrib>Fujisawa, Kou</creatorcontrib><creatorcontrib>Mito, Daisuke</creatorcontrib><creatorcontrib>Tomioka, Yoko</creatorcontrib><creatorcontrib>Kurita, Masakazu</creatorcontrib><creatorcontrib>Miyamoto, Shimpei</creatorcontrib><creatorcontrib>Iida, Takuya</creatorcontrib><creatorcontrib>Okazaki, Mutsumi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamashita, Shuji</au><au>Kitamura, Yutaro</au><au>Fujisawa, Kou</au><au>Mito, Daisuke</au><au>Tomioka, Yoko</au><au>Kurita, Masakazu</au><au>Miyamoto, Shimpei</au><au>Iida, Takuya</au><au>Okazaki, Mutsumi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Microsurgical Lymphovenous Anastomosis for Pelvic Lymphoceles after Gynecological Cancer Surgery</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2022-03</date><risdate>2022</risdate><volume>75</volume><issue>3</issue><spage>1142</spage><epage>1149</epage><pages>1142-1149</pages><issn>1748-6815</issn><eissn>1878-0539</eissn><abstract>Pelvic lymphoceles are the most common complications after pelvic lymphadenectomy. Microsurgical procedures have attracted attention as an alternative treatment for lymphoceles. Here, we report six cases of refractory lymphoceles that were successfully treated using lymphovenous anastomosis (LVA).
Six patients underwent surgery for gynecological cancers and developed pelvic lymphoceles, which did not respond to conventional treatment. We mainly performed LVA on the ipsilateral lower limbs, although some procedures were also performed on the contralateral limbs. The change in the lymphocele volume after LVA was examined using computed tomography and compared using the Wilcoxon test.
Five of the six refractory lymphocele cases were successfully treated using LVA, and the remaining case exhibited an 87% reduction in lymphocele volume. The average numbers of anastomoses were 6.7 on the ipsilateral side and 2.8 on the contralateral side (the median numbers: 6 [range: 5–9] vs. 3 [range: 1–4], P = 0.034). The average lymphocele volume decreased significantly from 414.0 mL preoperatively to 8.0 mL postoperatively (the median lymphocele volume: 255.8 [range: 61.5–1,329.2] vs. 0 [range: 0–47.7], P = 0.0313).
We found that microsurgical treatment was potentially effective for lymphoceles that did not respond to conventional treatment.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>34840117</pmid><doi>10.1016/j.bjps.2021.09.056</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3601-7739</orcidid><orcidid>https://orcid.org/0000-0003-4046-6713</orcidid><orcidid>https://orcid.org/0000-0001-7626-9565</orcidid><orcidid>https://orcid.org/0000-0003-4367-6927</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anastomosis, Surgical Female Gynecologic Surgical Procedures - adverse effects Humans Lymph Node Excision - adverse effects Lymph Node Excision - methods Lymphedema Lymphocele - etiology Lymphocele - surgery Lymphovenous anastomosis Microsurgery Neoplasms - surgery Pelvic lymphocele Pelvis - surgery |
| title | Microsurgical Lymphovenous Anastomosis for Pelvic Lymphoceles after Gynecological Cancer Surgery |
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