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. 2016 Jun 23;11(1):121-124.
doi: 10.1515/med-2016-0023. eCollection 2016.

Surgical treatment of recidivist lymphedema

Costantino Eretta  1 , Alessia Ferrarese  2 , Elisabetta Moggia  1 , Elisa Francone  1 , Carlo Sagnelli  1 , Maria Di Martino  1 , Stefano de Franciscis  3 , Bruno Amato  3 , Raffaele Grande  4 , Lucia Butrico  4 , Maurizio Amato  5 , Raffaele Serra  4 , Valter Martino  2 , Stefano Berti  1
Affiliations

Surgical treatment of recidivist lymphedema

Costantino Eretta et al. Open Med (Wars). .

Abstract

Lymphedema is a chronic disease with a progressively ingravescent evolvement and an appearance of recurrent complications of acute lymphangitic type; in nature it is mostly erysipeloid and responsible for a further rapid increase in the volume and consistency of edema. The purpose of this work is to present our experience in the minimally invasive treatment for recurrence of lymphedema; adapting techniques performed in the past which included large fasciotomy with devastating results cosmetically; but these techniques have been proposed again by the use of endoscopic equipment borrowed from the advanced laparoscopy surgery, which allows a monoskin access of about one cm.

Keywords: Lymphedema; lymphatic venous anastomosis; lymphoscintigraphy; microsurgery; supermicrosurgery; transposition of the lymph nodes.

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Figures

Figure 1
Figure 1
Mini invasive fasciotomy is performed by endoscopic technique, the skin incision of about 1 cm is performed at the middle third of the lateral and medial surface of the leg, the assistant holds camera and the first operator performs fasciotomy by mini laparoscopic scissors under vision.
Figure 2
Figure 2
Fasciotomy endoscopic, is created a wide fenestration exposing under fascial plans
Figure 3
Figure 3
sequence for execution of lymphatic venous anastomosis by technique supermicrosurgery performed by mini incision of 1 cm and packed to the operating microscope 20 magnification, in detail L indicates the lymphatic and V the vein.
Figure 4
Figure 4
Follow-up at 10 months A) preoperative situation B) 10 days post operative c) 10 months post operative
Figure 5
Figure 5
Histological examination: evidence of immunoreactivity of the muscle cells for actin and myosin dependent of lymphatic structures.
See this image and copyright information in PMC

References

    1. Becker C, Arrive L, Saaristo A, et al. Surgical treatment of congenital lymphedema. Clin Plast Surg. 2012 Oct;39(4):377–384. - PubMed
    1. Becker C, Assouad J, Riquet M, Hidden G. Postmastectomy lymphedema: long-term results following microsurgical lymph node transplantation. Ann Surg. 2006 Mar;243(3):313–315. - PMC - PubMed
    1. Boccardo F, Fulcheri E, Villa G. et al. Lymphatic microsurgery to treat lymphedema: techniques and indications for better results. Ann Plast Surg. 2013 Aug;71(2):191–195. - PubMed
    1. Campisi C, Bellini C, Campisi C. et al. Microsurgery for lymphedema: clinical research and long-term results. Microsurgery. 2010 May;30(4):256–260. - PubMed
    1. Campisi C, Eretta C, Pertile D. et al. Microsurgery for treatment of peripheral lymphedema: long-term outcome and future perspectives. Microsurgery. 2007;27(4):333–338. - PubMed

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