Efficacy Study of Lymphaticovenular Anastomosis via the Lymphosome-based Four-incision Approach for Lower Limb Lymphedema.

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders Pub Date : 2025-03-03 DOI:10.1016/j.jvsv.2025.102221

Chen Yang, Gejia Ma, Xuchuan Zhou, Aoshuang Qin, Bin Lin

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引用次数: 0

Abstract

Background: Lower limb lymphedema (LLL) is a chronic condition with impaired lymphatic drainage. Lymphaticovenular anastomosis (LVA) is a promising microsurgical treatment for LLL. Refined surgical techniques, such as optimal incision placement and precise lymphatic vessel identification, are essential for better clinical outcomes.

Objective: For patients with LLL, perform a lymphaticovenular anastomosis (LVA) via the lymphosome-based four-incision approach. Standardize incision positioning and identify lymphatic vessels for LVA to improve surgical outcomes.

Methods: A retrospective study was conducted on 59 patients with LLL who underwent LVA. Among them, 32 patients in the study group received LVA using the four-incision approach, and 27 patients in the control group underwent LVA with empirically determined incision placement. All patients were followed up for 12 months after the operation. The outcome measures included the number of lymphatic-to-venous anastomoses, surgical duration, Lymphedema Functioning, Disability, and Health Questionnaire for Lower Limb Lymphedema (Lymph-ICF) and Lower Extremity Lymphedema Index (LELI), Patient Health Questionnaire-9 items (PHQ-9) and subcutaneous thickness.

Result: At the 6-month and 12-month follow-ups, there was a significant interaction between the two groups of patients in terms of LELI and lymph-ICF (P < 0.05). The PHQ-9 has observed no interaction between the two groups (P > 0.05). After treatment, the subcutaneous thickness in the study group was lower than that in the control group (P < 0.05). There were no significant differences between the two groups regarding surgical duration and the number of lymphatic-to-venous anastomoses (P > 0.05).

Conclusion: LVA via the lymphosome-based four-incision approach can significantly enhance the quality of life, limb volume, and subcutaneous thickness in patients with LLL. This study presents new incision selection criteria for LVA and underlines the necessity of comprehensively addressing patients' mental health.

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来源期刊

Journal of vascular surgery. Venous and lymphatic disorders SURGERYPERIPHERAL VASCULAR DISEASE&n-PERIPHERAL VASCULAR DISEASE

CiteScore

6.30

自引率

18.80%

发文量

328

审稿时长

71 days

期刊介绍： Journal of Vascular Surgery: Venous and Lymphatic Disorders is one of a series of specialist journals launched by the Journal of Vascular Surgery. It aims to be the premier international Journal of medical, endovascular and surgical management of venous and lymphatic disorders. It publishes high quality clinical, research, case reports, techniques, and practice manuscripts related to all aspects of venous and lymphatic disorders, including malformations and wound care, with an emphasis on the practicing clinician. The journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals who treat patients presenting with vascular and lymphatic disorders. As the official publication of The Society for Vascular Surgery and the American Venous Forum, the Journal will publish, after peer review, selected papers presented at the annual meeting of these organizations and affiliated vascular societies, as well as original articles from members and non-members.