Dermato-adiposal lymphatic flap venous wrapping: a novel lymphaticovenous shunt method for progressed upper extremity lymphedema with severe lymphosclerosis

Takumi Yamamoto, Toko Miyazaki , Hayahito Sakai et al.
Dermato-adiposal lymphatic flap venous wrapping: a novel lymphaticovenous shunt method for progressed upper extremity lymphedema with severe lymphosclerosis
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Background

 Upper extremity lymphedema (UEL) significantly deteriorates quality of life (QOL) of breast cancer survivors. Lymphaticovenous shunt operation addresses pathophysiology of obstructive UEL, but its efficacy is limited in progressed UEL cases due to lymphosclerosis. This study aimed to evaluate feasibility of a new lymphaticovenous shunt method for progressed UEL.

Methods

 Patients who underwent dermato-adiposal lymphatic flap venous wrapping (DALF-VW) for the treatment of progressed UEL refractory to previous lymphaticovenular anastomosis (LVA) were included. A DALF was created where ICG lymphography showed dermal backflow, and was wrapped with a reflux-free recipient vein. Medical records were reviewed to obtain clinical and intraoperative findings. Characteristics of the patients and vessels, and postoperative results were evaluated.

Conclusions

DALF-VW was effective for progressed UEL refractory to previous LVA surgery. DALF-VW can be a useful option for progressed UEL with severe lymphosclerosis.

Read the full article here: https://pubmed.ncbi.nlm.nih.gov/36580998/

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