Practical Lymphatic Ultrasound for Supermicrosurgical Lymphaticovenous Anastomosis: Preoperative Lymphatic Mapping Using Conventional High-Frequency Ultrasound.

IF 1.4 4区医学 Q3 SURGERY

Annals of Plastic Surgery Pub Date : 2025-05-07 DOI:10.1097/SAP.0000000000004406

Paloma Malagón, Takumi Yamamoto

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引用次数: 0

Abstract

Background: Ultrasound (US) has many advantages and is useful for mapping lymph vessels and veins for lymphovenous anastomosis (LVA) and improving their outcomes. However, it is operator-dependent and required some experience. Our aim was to describe how to perform preoperative mapping of LVA using high-frequency US (HFUS) in B mode.

Methods: Experiences about preoperative planning of LVA surgeries in patients with upper and lower limb lymphedema using HFUS were the basis of our guide. In addition, data of women with secondary lower limb lymphedema who undergone LVA was analyzed. US examination was performed on the previous day of surgery for mapping lymph vessels and veins using a linear transducer of 18 MHz and B mode.

Results: A standardized method to perform step by step the preoperative planning of LVA using HFUS was described. A total of 349 incisions performed in 97 lower limbs were analyzed. The overall success rate for identifying lymph vessels was 99.7%. Mean diameters of lymph vessels and veins were 0.65 mm and 0.81 mm, respectively. Skin incision length was 1.97 cm (range, 1.2-3.8 cm). Surgical time for each LVA was 21.7 minutes (range, 13-47 min). There were a reduction of limb volume index (281.2 vs 267.6, P = 0.002) and an improvement in the quality of life of patients (48.3 vs 21.9, P < 0.001).

Conclusions: A standardized method can be followed to effectively perform the preoperative mapping of LVA using HFUS to reduce the limb volume and improve the quality of life of patients with lymphedema.

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实用淋巴超声在超显微手术淋巴-静脉吻合术中的应用：术前使用常规高频超声进行淋巴定位。

背景：超声（US）具有许多优点，对淋巴静脉吻合（LVA）的淋巴管和静脉的定位和改善其预后是有用的。然而，它依赖于操作人员，并且需要一些经验。我们的目的是描述如何在B模式下使用高频超声（HFUS）进行LVA的术前制图。方法：利用高通量法对上肢和下肢淋巴水肿患者进行LVA手术的术前规划经验，作为指导的基础。此外，还分析了继发性下肢淋巴水肿妇女行LVA的资料。在手术前一天进行US检查，使用18 MHz和B模式的线性换能器绘制淋巴管和静脉。结果：描述了一种标准化的方法，采用HFUS进行LVA术前分步计划。对97例下肢349个切口进行分析。淋巴血管识别的总成功率为99.7%。淋巴管和静脉的平均直径分别为0.65 mm和0.81 mm。皮肤切口长度1.97 cm（范围1.2 ~ 3.8 cm）。每个LVA的手术时间为21.7分钟（范围13-47分钟）。肢体体积指数降低（281.2 vs 267.6, P = 0.002），患者生活质量改善（48.3 vs 21.9, P < 0.001）。结论：采用标准化的方法可有效地进行HFUS术前LVA定位，减少肢体体积，提高淋巴水肿患者的生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Plastic Surgery 医学-外科

CiteScore

2.70

自引率

13.30%

发文量

584

审稿时长

6 months

期刊介绍： The only independent journal devoted to general plastic and reconstructive surgery, Annals of Plastic Surgery serves as a forum for current scientific and clinical advances in the field and a sounding board for ideas and perspectives on its future. The journal publishes peer-reviewed original articles, brief communications, case reports, and notes in all areas of interest to the practicing plastic surgeon. There are also historical and current reviews, descriptions of surgical technique, and lively editorials and letters to the editor.