Comparison of Outcomes between Side-to-End and End-to-End Lymphovenous Anastomoses for Early-Grade Extremity Lymphedema
Lymphovenous anastomosis is technically challenging and can be successfully performed with an advanced operating microscope, supermicrosurgical instruments, and indocyanine green lymphography. This study compared the outcomes between side-to-end and end-to-end lymphovenous anastomosis configurations...
Gespeichert in:
| Veröffentlicht in: | Plastic and reconstructive surgery (1963) 2019-08, Vol.144 (2), p.486 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 2 |
| container_start_page | 486 |
| container_title | Plastic and reconstructive surgery (1963) |
| container_volume | 144 |
| creator | AlJindan, Fahad K Lin, Chia-Yu Cheng, Ming-Huei |
| description | Lymphovenous anastomosis is technically challenging and can be successfully performed with an advanced operating microscope, supermicrosurgical instruments, and indocyanine green lymphography. This study compared the outcomes between side-to-end and end-to-end lymphovenous anastomosis configurations for unilateral extremity lymphedema.
Between April of 2013 and June of 2017, lymphovenous anastomosis was indicated for 58 patients who preoperatively had patent lymphatic ducts by indocyanine green lymphography, including 20 patients with upper limb lymphedema and 38 patients with lower limb lymphedema. Either an end-to-end or a side-to-end lymphovenous anastomosis was used to anastomose the subdermal venule to the lymphatic duct. The circumferential difference and episodes of cellulitis were used as outcome measurements.
Twenty-three patients underwent an end-to-end lymphovenous anastomosis and 35 patients underwent side-to-end lymphovenous anastomosis. All patients had an immediate patency evaluated by indocyanine green lymphography and patent blue assessments. All patients returned to their daily routine without the use of any compression garments. At an average follow-up of 16.5 months (range, 13.4 to 19.6 months), the improvement of circumferential difference (3.2 percent; range, 1.8 to 4.6 percent) in the side-to-end group was statistically greater than that in the end-to-end group (2.2 percent; range, 1 to 3.4 percent; p = 0.04). The overall episodes of cellulitis were significantly reduced from 1.7 times/year (range, 1.3 to 2.1 times/year) to 0.7 times/year (range, 0.3 to 1.1 times/year; p < 0.001), but no difference was observed between the two groups.
Both side-to-end and end-to-end lymphovenous anastomosis configurations were effective surgical approaches for improving early-grade extremity lymphedema. Side-to-end lymphovenous anastomosis has the advantages of having greater efficacy for lymph drainage, requiring only one anastomosis and eliminating the need to use compression garments.
Therapeutic, III. |
| doi_str_mv | 10.1097/PRS.0000000000005870 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed</sourceid><recordid>TN_cdi_pubmed_primary_31348365</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>31348365</sourcerecordid><originalsourceid>FETCH-LOGICAL-p108t-79c70fe1d30b0e25f5f46b884fe43d50304237e23f9df093e07768e9e7b9ccc13</originalsourceid><addsrcrecordid>eNpNUFFLwzAYDIK4Of0HIvkD0S9NujSPY9QpDCZOn0fafMHK0pSkc_bfW5gDD467e7h7OELuODxw0Orx9W37AP-QFwouyJTnmWYyk9mEXKf0BcCVmOdXZCK4kMVop-S4DL4zsUmhpcHRzaGvg8dEK-yPiC3dNhZZH1jZWmpGjnqO68F3n-Eb23BIdNGa1Acf0th1IdLSxP3AVtFYpOVPH9E3_XCqoEVvbsilM_uEt386Ix9P5fvyma03q5flYs06DkXPlK4VOORWQAWY5S53cl4VhXQohc1BgMyEwkw4bR1ogaDUvECNqtJ1XXMxI_en3e5QebS7LjbexGF3fkD8AunEXgw</addsrcrecordid><sourcetype>Index Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Comparison of Outcomes between Side-to-End and End-to-End Lymphovenous Anastomoses for Early-Grade Extremity Lymphedema</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>AlJindan, Fahad K ; Lin, Chia-Yu ; Cheng, Ming-Huei</creator><creatorcontrib>AlJindan, Fahad K ; Lin, Chia-Yu ; Cheng, Ming-Huei</creatorcontrib><description>Lymphovenous anastomosis is technically challenging and can be successfully performed with an advanced operating microscope, supermicrosurgical instruments, and indocyanine green lymphography. This study compared the outcomes between side-to-end and end-to-end lymphovenous anastomosis configurations for unilateral extremity lymphedema.
Between April of 2013 and June of 2017, lymphovenous anastomosis was indicated for 58 patients who preoperatively had patent lymphatic ducts by indocyanine green lymphography, including 20 patients with upper limb lymphedema and 38 patients with lower limb lymphedema. Either an end-to-end or a side-to-end lymphovenous anastomosis was used to anastomose the subdermal venule to the lymphatic duct. The circumferential difference and episodes of cellulitis were used as outcome measurements.
Twenty-three patients underwent an end-to-end lymphovenous anastomosis and 35 patients underwent side-to-end lymphovenous anastomosis. All patients had an immediate patency evaluated by indocyanine green lymphography and patent blue assessments. All patients returned to their daily routine without the use of any compression garments. At an average follow-up of 16.5 months (range, 13.4 to 19.6 months), the improvement of circumferential difference (3.2 percent; range, 1.8 to 4.6 percent) in the side-to-end group was statistically greater than that in the end-to-end group (2.2 percent; range, 1 to 3.4 percent; p = 0.04). The overall episodes of cellulitis were significantly reduced from 1.7 times/year (range, 1.3 to 2.1 times/year) to 0.7 times/year (range, 0.3 to 1.1 times/year; p < 0.001), but no difference was observed between the two groups.
Both side-to-end and end-to-end lymphovenous anastomosis configurations were effective surgical approaches for improving early-grade extremity lymphedema. Side-to-end lymphovenous anastomosis has the advantages of having greater efficacy for lymph drainage, requiring only one anastomosis and eliminating the need to use compression garments.
Therapeutic, III.</description><identifier>EISSN: 1529-4242</identifier><identifier>DOI: 10.1097/PRS.0000000000005870</identifier><identifier>PMID: 31348365</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Aged ; Anastomosis, Surgical ; Chi-Square Distribution ; China ; Cohort Studies ; Female ; Humans ; Lower Extremity - surgery ; Lymphatic Vessels - diagnostic imaging ; Lymphatic Vessels - surgery ; Lymphedema - diagnostic imaging ; Lymphedema - surgery ; Lymphography - methods ; Male ; Microsurgery - methods ; Middle Aged ; Prognosis ; Recovery of Function ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Statistics, Nonparametric ; Upper Extremity - surgery ; Vascular Patency - physiology ; Vascular Surgical Procedures - methods</subject><ispartof>Plastic and reconstructive surgery (1963), 2019-08, Vol.144 (2), p.486</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31348365$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>AlJindan, Fahad K</creatorcontrib><creatorcontrib>Lin, Chia-Yu</creatorcontrib><creatorcontrib>Cheng, Ming-Huei</creatorcontrib><title>Comparison of Outcomes between Side-to-End and End-to-End Lymphovenous Anastomoses for Early-Grade Extremity Lymphedema</title><title>Plastic and reconstructive surgery (1963)</title><addtitle>Plast Reconstr Surg</addtitle><description>Lymphovenous anastomosis is technically challenging and can be successfully performed with an advanced operating microscope, supermicrosurgical instruments, and indocyanine green lymphography. This study compared the outcomes between side-to-end and end-to-end lymphovenous anastomosis configurations for unilateral extremity lymphedema.
Between April of 2013 and June of 2017, lymphovenous anastomosis was indicated for 58 patients who preoperatively had patent lymphatic ducts by indocyanine green lymphography, including 20 patients with upper limb lymphedema and 38 patients with lower limb lymphedema. Either an end-to-end or a side-to-end lymphovenous anastomosis was used to anastomose the subdermal venule to the lymphatic duct. The circumferential difference and episodes of cellulitis were used as outcome measurements.
Twenty-three patients underwent an end-to-end lymphovenous anastomosis and 35 patients underwent side-to-end lymphovenous anastomosis. All patients had an immediate patency evaluated by indocyanine green lymphography and patent blue assessments. All patients returned to their daily routine without the use of any compression garments. At an average follow-up of 16.5 months (range, 13.4 to 19.6 months), the improvement of circumferential difference (3.2 percent; range, 1.8 to 4.6 percent) in the side-to-end group was statistically greater than that in the end-to-end group (2.2 percent; range, 1 to 3.4 percent; p = 0.04). The overall episodes of cellulitis were significantly reduced from 1.7 times/year (range, 1.3 to 2.1 times/year) to 0.7 times/year (range, 0.3 to 1.1 times/year; p < 0.001), but no difference was observed between the two groups.
Both side-to-end and end-to-end lymphovenous anastomosis configurations were effective surgical approaches for improving early-grade extremity lymphedema. Side-to-end lymphovenous anastomosis has the advantages of having greater efficacy for lymph drainage, requiring only one anastomosis and eliminating the need to use compression garments.
Therapeutic, III.</description><subject>Adult</subject><subject>Aged</subject><subject>Anastomosis, Surgical</subject><subject>Chi-Square Distribution</subject><subject>China</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Lower Extremity - surgery</subject><subject>Lymphatic Vessels - diagnostic imaging</subject><subject>Lymphatic Vessels - surgery</subject><subject>Lymphedema - diagnostic imaging</subject><subject>Lymphedema - surgery</subject><subject>Lymphography - methods</subject><subject>Male</subject><subject>Microsurgery - methods</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Recovery of Function</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Statistics, Nonparametric</subject><subject>Upper Extremity - surgery</subject><subject>Vascular Patency - physiology</subject><subject>Vascular Surgical Procedures - methods</subject><issn>1529-4242</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNUFFLwzAYDIK4Of0HIvkD0S9NujSPY9QpDCZOn0fafMHK0pSkc_bfW5gDD467e7h7OELuODxw0Orx9W37AP-QFwouyJTnmWYyk9mEXKf0BcCVmOdXZCK4kMVop-S4DL4zsUmhpcHRzaGvg8dEK-yPiC3dNhZZH1jZWmpGjnqO68F3n-Eb23BIdNGa1Acf0th1IdLSxP3AVtFYpOVPH9E3_XCqoEVvbsilM_uEt386Ix9P5fvyma03q5flYs06DkXPlK4VOORWQAWY5S53cl4VhXQohc1BgMyEwkw4bR1ogaDUvECNqtJ1XXMxI_en3e5QebS7LjbexGF3fkD8AunEXgw</recordid><startdate>201908</startdate><enddate>201908</enddate><creator>AlJindan, Fahad K</creator><creator>Lin, Chia-Yu</creator><creator>Cheng, Ming-Huei</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>201908</creationdate><title>Comparison of Outcomes between Side-to-End and End-to-End Lymphovenous Anastomoses for Early-Grade Extremity Lymphedema</title><author>AlJindan, Fahad K ; Lin, Chia-Yu ; Cheng, Ming-Huei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p108t-79c70fe1d30b0e25f5f46b884fe43d50304237e23f9df093e07768e9e7b9ccc13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anastomosis, Surgical</topic><topic>Chi-Square Distribution</topic><topic>China</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Lower Extremity - surgery</topic><topic>Lymphatic Vessels - diagnostic imaging</topic><topic>Lymphatic Vessels - surgery</topic><topic>Lymphedema - diagnostic imaging</topic><topic>Lymphedema - surgery</topic><topic>Lymphography - methods</topic><topic>Male</topic><topic>Microsurgery - methods</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Recovery of Function</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Statistics, Nonparametric</topic><topic>Upper Extremity - surgery</topic><topic>Vascular Patency - physiology</topic><topic>Vascular Surgical Procedures - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>AlJindan, Fahad K</creatorcontrib><creatorcontrib>Lin, Chia-Yu</creatorcontrib><creatorcontrib>Cheng, Ming-Huei</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Plastic and reconstructive surgery (1963)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>AlJindan, Fahad K</au><au>Lin, Chia-Yu</au><au>Cheng, Ming-Huei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of Outcomes between Side-to-End and End-to-End Lymphovenous Anastomoses for Early-Grade Extremity Lymphedema</atitle><jtitle>Plastic and reconstructive surgery (1963)</jtitle><addtitle>Plast Reconstr Surg</addtitle><date>2019-08</date><risdate>2019</risdate><volume>144</volume><issue>2</issue><spage>486</spage><pages>486-</pages><eissn>1529-4242</eissn><abstract>Lymphovenous anastomosis is technically challenging and can be successfully performed with an advanced operating microscope, supermicrosurgical instruments, and indocyanine green lymphography. This study compared the outcomes between side-to-end and end-to-end lymphovenous anastomosis configurations for unilateral extremity lymphedema.
Between April of 2013 and June of 2017, lymphovenous anastomosis was indicated for 58 patients who preoperatively had patent lymphatic ducts by indocyanine green lymphography, including 20 patients with upper limb lymphedema and 38 patients with lower limb lymphedema. Either an end-to-end or a side-to-end lymphovenous anastomosis was used to anastomose the subdermal venule to the lymphatic duct. The circumferential difference and episodes of cellulitis were used as outcome measurements.
Twenty-three patients underwent an end-to-end lymphovenous anastomosis and 35 patients underwent side-to-end lymphovenous anastomosis. All patients had an immediate patency evaluated by indocyanine green lymphography and patent blue assessments. All patients returned to their daily routine without the use of any compression garments. At an average follow-up of 16.5 months (range, 13.4 to 19.6 months), the improvement of circumferential difference (3.2 percent; range, 1.8 to 4.6 percent) in the side-to-end group was statistically greater than that in the end-to-end group (2.2 percent; range, 1 to 3.4 percent; p = 0.04). The overall episodes of cellulitis were significantly reduced from 1.7 times/year (range, 1.3 to 2.1 times/year) to 0.7 times/year (range, 0.3 to 1.1 times/year; p < 0.001), but no difference was observed between the two groups.
Both side-to-end and end-to-end lymphovenous anastomosis configurations were effective surgical approaches for improving early-grade extremity lymphedema. Side-to-end lymphovenous anastomosis has the advantages of having greater efficacy for lymph drainage, requiring only one anastomosis and eliminating the need to use compression garments.
Therapeutic, III.</abstract><cop>United States</cop><pmid>31348365</pmid><doi>10.1097/PRS.0000000000005870</doi></addata></record> |
| fulltext | fulltext |
| identifier | EISSN: 1529-4242 |
| ispartof | Plastic and reconstructive surgery (1963), 2019-08, Vol.144 (2), p.486 |
| issn | 1529-4242 |
| language | eng |
| recordid | cdi_pubmed_primary_31348365 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Aged Anastomosis, Surgical Chi-Square Distribution China Cohort Studies Female Humans Lower Extremity - surgery Lymphatic Vessels - diagnostic imaging Lymphatic Vessels - surgery Lymphedema - diagnostic imaging Lymphedema - surgery Lymphography - methods Male Microsurgery - methods Middle Aged Prognosis Recovery of Function Retrospective Studies Risk Assessment Severity of Illness Index Statistics, Nonparametric Upper Extremity - surgery Vascular Patency - physiology Vascular Surgical Procedures - methods |
| title | Comparison of Outcomes between Side-to-End and End-to-End Lymphovenous Anastomoses for Early-Grade Extremity Lymphedema |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-10T04%3A21%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-pubmed&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Comparison%20of%20Outcomes%20between%20Side-to-End%20and%20End-to-End%20Lymphovenous%20Anastomoses%20for%20Early-Grade%20Extremity%20Lymphedema&rft.jtitle=Plastic%20and%20reconstructive%20surgery%20(1963)&rft.au=AlJindan,%20Fahad%20K&rft.date=2019-08&rft.volume=144&rft.issue=2&rft.spage=486&rft.pages=486-&rft.eissn=1529-4242&rft_id=info:doi/10.1097/PRS.0000000000005870&rft_dat=%3Cpubmed%3E31348365%3C/pubmed%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/31348365&rfr_iscdi=true |