Reconstructive microsurgery of lymph vessels: The personal method of lymphatic-venous-lymphatic (LVL) interpositioned grafted shunt
✍ Scribed by Prof. C. Campisi; F. Boccardo; M. Tacchella
- Publisher
- John Wiley and Sons
- Year
- 1995
- Tongue
- English
- Weight
- 623 KB
- Volume
- 16
- Category
- Article
- ISSN
- 0738-1085
No coin nor oath required. For personal study only.
✦ Synopsis
Abstract
Our clinical observations in 64 patients affected by chronic obstructive lymphedema (either arm or leg) undergoing interposition autologous lymphatic‐venous‐lymphatic (LVL) anastomoses are reported. This microsurgical technique is an alternative to other lymphatic shunting methods, especially when venous dysfunction coexists in the same limb and, therefore, when direct lymphatic‐venous anastomosis is accordingly inadequate. Preoperative diagnostic evaluation (including lymphatic and venous isotopic scintigraphy, Doppler venous flowmetrics, and pressure manometry) plays an essential role in assessing the conditions of both the lymphatic and venous systems and in establishing which microsurgical procedure, if any, is indicated. Our microsurgical technique consists of inserting suitably large and lengthy autologous venous grafts between lymphatic collectors above and below the site of obstruction to lymph flow. The data show that, using this technique, both limb function and edema improved, and in all patients followed up for over 5 years edema regression was permanent. © 1995 Wiley‐Liss, Inc.