J Reconstr Microsurg 2000; 16(6): 437-442
DOI: 10.1055/s-2006-947150
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Supermicrosurgical Lymphaticovenular Anastomosis for the Treatment of Lymphedema in the Upper Extremities

Isao Koshima1 , Kiichi Inagawa1 , Katsuyuki Urushibara1 , Takahiko Moriguchi1
  • 1Department of Plastic and Reconstructive Surgery, Okayama University Medical School and Kawasaki Medical School, Okayama, Japan
Further Information

Publication History

Accepted: February 23, 2000

Publication Date:
08 June 2006 (online)

ABSTRACT

Over the last eight years, the authors analyzed obstructive lymphedema of a unilateral upper extremity in a total of 27 females, comparing the use of supramicrosurgical lymphaticovenule anastomoses and/or conservative treatment. The most common cause of edema was mastectomy, with or without subsequent radiation therapy for breast cancer. As an objective assessment of the extent of edema, the circumferences of the affected and opposite normal forearms were measured at 10 cm below the olecranon of the arm. Twelve of these patients received continual bandaging. In these patients, the average excess circumference of the affected arm was 6.4 cm over that of the normal forearm; the average duration of edema before treatment was 3.5 years; the average period for conservative treatment was 10.6 months; and the average decrease in circumference was 0.8 cm (11.7 percent of the preoperative excess). Twelve patients underwent surgery and postoperative continual bandaging. In these patients, the average excess circumference was 8.9 cm; the average duration of edema before surgery was 8.2 years; the average follow-up after surgery was 2.2 years; and the average decrease in circumference was 4.1 cm (47.3 percent of the preoperative excess). These results indicated that supermicrolymphaticovenular anastomoses with postoperative bandaging have a valuable place in the treatment of obstructive lymphedema.

 Dr.
Koshima

Dept. of Plastic and Reconstructive Surgery, Okayama University Medical School

2-5-1 Shikata-cho, Okayama City, 700-8558, Japan