Indocyanine green-guided liposuction for patients presenting with residual nonpitting edema after lymphovenous anastomosis
Lymphovenous anastomoses (LVA) techniques for the treatment of lymphedema are well defined, and results restoring lymph function are reported in the literature. However, unsatisfactory results (poor-responders) are common, leading to persistent nonpitting edema. Blind liposuction eliminates fat and...
Gespeichert in:
Veröffentlicht in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2022-08, Vol.75 (8), p.2482-2492 |
---|---|
Hauptverfasser: | , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 2492 |
---|---|
container_issue | 8 |
container_start_page | 2482 |
container_title | Journal of plastic, reconstructive & aesthetic surgery |
container_volume | 75 |
creator | Lasso, J.M. Alonso-Farto, J.C. |
description | Lymphovenous anastomoses (LVA) techniques for the treatment of lymphedema are well defined, and results restoring lymph function are reported in the literature. However, unsatisfactory results (poor-responders) are common, leading to persistent nonpitting edema. Blind liposuction eliminates fat and fibrous tissue but may result in inadvertent damage to the lymph vessel system. Indocyanine green imaging of the lymphatic system provides the potential preservation of functioning lymphatics while conducting liposuction to address the excess adipose and fibrous tissue in these patients.
Our study reports the results of a prospectively conducted technique in patients with nonpitting edema after failing previous LVA. It consists of indocyanine green-guided liposuction.
Twenty poor-responders patients to LVA who presented with persistent nonpitting edema were operated with liposuction.
Limb volume measurements, SPECT-CT/lymphoscintigraphy, and ICG lymphography were recorded and complemented with a satisfaction inquiry.
The overall percentage of volume reduction was 46.2% after liposuction (p = 0.001). None of our patients reported any set back with respect to the improvements they had achieved after LVA nor new infections. Satisfaction showed a mean improvement of 5 points in a 20-point scale.
SPECT-CT/lymphoscintigraphy showed further improvements in 17 cases after liposuction, such as dermal back-flow reduction, spots along the lymphatic system, or lymph nodes not described in preoperative reports, without showing significant differences when compared with overall volume reduction (p = 0.12).
Controlled liposuction with ICG seems to be an effective technique for the reduction of residual non-pitting edema in poor responder patients after LVA. Overall, volume excess reduction after liposuction was 42.6%. |
doi_str_mv | 10.1016/j.bjps.2022.02.081 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2648062326</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1748681522001619</els_id><sourcerecordid>2648062326</sourcerecordid><originalsourceid>FETCH-LOGICAL-c263t-48cc4e6a71aff44fe33bf4092e51f71d56686a7abf83fbb077f20071d87b0bf13</originalsourceid><addsrcrecordid>eNp9UE1LxDAQDaKgrv4BTzl6aU3StI3gRRY_FgQveg5pOlmztElN0pX115t1PQsPZoY3bz4eQleUlJTQ5mZTdpsplowwVpIMQY_QGRWtKEhd3R7nvOWiaAStT9F5jBtCeEV5fYa-V673eqecdYDXAcAV69n20OPBTj7OOlnvsPEBTypZcCniKUDMiXVr_GXTB86l7Wc1YOfdZNMvAT2MCiuTIOBhN04ffgvOzxErp2Lyo482XqATo4YIl39xgd4fH96Wz8XL69Nqef9SaNZUqeBCaw6NaqkyhnMDVdUZTm4Z1NS0tK-bRmRWdUZUputI2xpGSCZE25HO0GqBrg9zp-A_Z4hJjjZqGAblIJ8kWcMFaViVty0QO7Tq4GMMYOQU7KjCTlIi90bLjdwbLfdGS5Ih9vPvDiLIT2wtBBl1dkpDbwPoJHtv_5P_AO1Zi2s</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2648062326</pqid></control><display><type>article</type><title>Indocyanine green-guided liposuction for patients presenting with residual nonpitting edema after lymphovenous anastomosis</title><source>Elsevier ScienceDirect Journals</source><creator>Lasso, J.M. ; Alonso-Farto, J.C.</creator><creatorcontrib>Lasso, J.M. ; Alonso-Farto, J.C.</creatorcontrib><description>Lymphovenous anastomoses (LVA) techniques for the treatment of lymphedema are well defined, and results restoring lymph function are reported in the literature. However, unsatisfactory results (poor-responders) are common, leading to persistent nonpitting edema. Blind liposuction eliminates fat and fibrous tissue but may result in inadvertent damage to the lymph vessel system. Indocyanine green imaging of the lymphatic system provides the potential preservation of functioning lymphatics while conducting liposuction to address the excess adipose and fibrous tissue in these patients.
Our study reports the results of a prospectively conducted technique in patients with nonpitting edema after failing previous LVA. It consists of indocyanine green-guided liposuction.
Twenty poor-responders patients to LVA who presented with persistent nonpitting edema were operated with liposuction.
Limb volume measurements, SPECT-CT/lymphoscintigraphy, and ICG lymphography were recorded and complemented with a satisfaction inquiry.
The overall percentage of volume reduction was 46.2% after liposuction (p = 0.001). None of our patients reported any set back with respect to the improvements they had achieved after LVA nor new infections. Satisfaction showed a mean improvement of 5 points in a 20-point scale.
SPECT-CT/lymphoscintigraphy showed further improvements in 17 cases after liposuction, such as dermal back-flow reduction, spots along the lymphatic system, or lymph nodes not described in preoperative reports, without showing significant differences when compared with overall volume reduction (p = 0.12).
Controlled liposuction with ICG seems to be an effective technique for the reduction of residual non-pitting edema in poor responder patients after LVA. Overall, volume excess reduction after liposuction was 42.6%.</description><identifier>ISSN: 1748-6815</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2022.02.081</identifier><language>eng</language><publisher>Elsevier Ltd</publisher><subject>ICG-supported liposuction ; Lipectomy ; LVA ; Lymphedema ; Lympho-SPECT/CT ; Lymphovenous anastomosis ; Microsurgery</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2022-08, Vol.75 (8), p.2482-2492</ispartof><rights>2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c263t-48cc4e6a71aff44fe33bf4092e51f71d56686a7abf83fbb077f20071d87b0bf13</citedby><cites>FETCH-LOGICAL-c263t-48cc4e6a71aff44fe33bf4092e51f71d56686a7abf83fbb077f20071d87b0bf13</cites><orcidid>0000-0002-3386-5823</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1748681522001619$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids></links><search><creatorcontrib>Lasso, J.M.</creatorcontrib><creatorcontrib>Alonso-Farto, J.C.</creatorcontrib><title>Indocyanine green-guided liposuction for patients presenting with residual nonpitting edema after lymphovenous anastomosis</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><description>Lymphovenous anastomoses (LVA) techniques for the treatment of lymphedema are well defined, and results restoring lymph function are reported in the literature. However, unsatisfactory results (poor-responders) are common, leading to persistent nonpitting edema. Blind liposuction eliminates fat and fibrous tissue but may result in inadvertent damage to the lymph vessel system. Indocyanine green imaging of the lymphatic system provides the potential preservation of functioning lymphatics while conducting liposuction to address the excess adipose and fibrous tissue in these patients.
Our study reports the results of a prospectively conducted technique in patients with nonpitting edema after failing previous LVA. It consists of indocyanine green-guided liposuction.
Twenty poor-responders patients to LVA who presented with persistent nonpitting edema were operated with liposuction.
Limb volume measurements, SPECT-CT/lymphoscintigraphy, and ICG lymphography were recorded and complemented with a satisfaction inquiry.
The overall percentage of volume reduction was 46.2% after liposuction (p = 0.001). None of our patients reported any set back with respect to the improvements they had achieved after LVA nor new infections. Satisfaction showed a mean improvement of 5 points in a 20-point scale.
SPECT-CT/lymphoscintigraphy showed further improvements in 17 cases after liposuction, such as dermal back-flow reduction, spots along the lymphatic system, or lymph nodes not described in preoperative reports, without showing significant differences when compared with overall volume reduction (p = 0.12).
Controlled liposuction with ICG seems to be an effective technique for the reduction of residual non-pitting edema in poor responder patients after LVA. Overall, volume excess reduction after liposuction was 42.6%.</description><subject>ICG-supported liposuction</subject><subject>Lipectomy</subject><subject>LVA</subject><subject>Lymphedema</subject><subject>Lympho-SPECT/CT</subject><subject>Lymphovenous anastomosis</subject><subject>Microsurgery</subject><issn>1748-6815</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9UE1LxDAQDaKgrv4BTzl6aU3StI3gRRY_FgQveg5pOlmztElN0pX115t1PQsPZoY3bz4eQleUlJTQ5mZTdpsplowwVpIMQY_QGRWtKEhd3R7nvOWiaAStT9F5jBtCeEV5fYa-V673eqecdYDXAcAV69n20OPBTj7OOlnvsPEBTypZcCniKUDMiXVr_GXTB86l7Wc1YOfdZNMvAT2MCiuTIOBhN04ffgvOzxErp2Lyo482XqATo4YIl39xgd4fH96Wz8XL69Nqef9SaNZUqeBCaw6NaqkyhnMDVdUZTm4Z1NS0tK-bRmRWdUZUputI2xpGSCZE25HO0GqBrg9zp-A_Z4hJjjZqGAblIJ8kWcMFaViVty0QO7Tq4GMMYOQU7KjCTlIi90bLjdwbLfdGS5Ih9vPvDiLIT2wtBBl1dkpDbwPoJHtv_5P_AO1Zi2s</recordid><startdate>202208</startdate><enddate>202208</enddate><creator>Lasso, J.M.</creator><creator>Alonso-Farto, J.C.</creator><general>Elsevier Ltd</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3386-5823</orcidid></search><sort><creationdate>202208</creationdate><title>Indocyanine green-guided liposuction for patients presenting with residual nonpitting edema after lymphovenous anastomosis</title><author>Lasso, J.M. ; Alonso-Farto, J.C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c263t-48cc4e6a71aff44fe33bf4092e51f71d56686a7abf83fbb077f20071d87b0bf13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>ICG-supported liposuction</topic><topic>Lipectomy</topic><topic>LVA</topic><topic>Lymphedema</topic><topic>Lympho-SPECT/CT</topic><topic>Lymphovenous anastomosis</topic><topic>Microsurgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lasso, J.M.</creatorcontrib><creatorcontrib>Alonso-Farto, J.C.</creatorcontrib><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>Lasso, J.M.</au><au>Alonso-Farto, J.C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Indocyanine green-guided liposuction for patients presenting with residual nonpitting edema after lymphovenous anastomosis</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><date>2022-08</date><risdate>2022</risdate><volume>75</volume><issue>8</issue><spage>2482</spage><epage>2492</epage><pages>2482-2492</pages><issn>1748-6815</issn><eissn>1878-0539</eissn><abstract>Lymphovenous anastomoses (LVA) techniques for the treatment of lymphedema are well defined, and results restoring lymph function are reported in the literature. However, unsatisfactory results (poor-responders) are common, leading to persistent nonpitting edema. Blind liposuction eliminates fat and fibrous tissue but may result in inadvertent damage to the lymph vessel system. Indocyanine green imaging of the lymphatic system provides the potential preservation of functioning lymphatics while conducting liposuction to address the excess adipose and fibrous tissue in these patients.
Our study reports the results of a prospectively conducted technique in patients with nonpitting edema after failing previous LVA. It consists of indocyanine green-guided liposuction.
Twenty poor-responders patients to LVA who presented with persistent nonpitting edema were operated with liposuction.
Limb volume measurements, SPECT-CT/lymphoscintigraphy, and ICG lymphography were recorded and complemented with a satisfaction inquiry.
The overall percentage of volume reduction was 46.2% after liposuction (p = 0.001). None of our patients reported any set back with respect to the improvements they had achieved after LVA nor new infections. Satisfaction showed a mean improvement of 5 points in a 20-point scale.
SPECT-CT/lymphoscintigraphy showed further improvements in 17 cases after liposuction, such as dermal back-flow reduction, spots along the lymphatic system, or lymph nodes not described in preoperative reports, without showing significant differences when compared with overall volume reduction (p = 0.12).
Controlled liposuction with ICG seems to be an effective technique for the reduction of residual non-pitting edema in poor responder patients after LVA. Overall, volume excess reduction after liposuction was 42.6%.</abstract><pub>Elsevier Ltd</pub><doi>10.1016/j.bjps.2022.02.081</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-3386-5823</orcidid></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1748-6815 |
ispartof | Journal of plastic, reconstructive & aesthetic surgery, 2022-08, Vol.75 (8), p.2482-2492 |
issn | 1748-6815 1878-0539 |
language | eng |
recordid | cdi_proquest_miscellaneous_2648062326 |
source | Elsevier ScienceDirect Journals |
subjects | ICG-supported liposuction Lipectomy LVA Lymphedema Lympho-SPECT/CT Lymphovenous anastomosis Microsurgery |
title | Indocyanine green-guided liposuction for patients presenting with residual nonpitting edema after lymphovenous anastomosis |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T11%3A28%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Indocyanine%20green-guided%20liposuction%20for%20patients%20presenting%20with%20residual%20nonpitting%20edema%20after%20lymphovenous%20anastomosis&rft.jtitle=Journal%20of%20plastic,%20reconstructive%20&%20aesthetic%20surgery&rft.au=Lasso,%20J.M.&rft.date=2022-08&rft.volume=75&rft.issue=8&rft.spage=2482&rft.epage=2492&rft.pages=2482-2492&rft.issn=1748-6815&rft.eissn=1878-0539&rft_id=info:doi/10.1016/j.bjps.2022.02.081&rft_dat=%3Cproquest_cross%3E2648062326%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2648062326&rft_id=info:pmid/&rft_els_id=S1748681522001619&rfr_iscdi=true |