Single Lymphaticovenular Anastomosis for Early-Stage Lower Extremity Lymphedema Treated by the...

Area of Science:

• Vascular Surgery
• Lymphedema Management
• Microsurgery

Background:

• Surgical treatment for lower extremity lymphedema (LEL) presents significant challenges.
• The superior-edge-of-the-knee incision for lymphaticovenular anastomosis (LVA) enhances lymph-to-venous flow, leveraging knee movement during ambulation.
• This study evaluates the efficacy of a single LVA using this specific incision for early-stage LEL.

Purpose of the Study:

• To assess the therapeutic effectiveness of a single lymphaticovenular anastomosis (LVA) in patients with early-stage lower extremity lymphedema (LEL).
• To determine if the superior-edge-of-the-knee incision method is adequate for treating stage 2 and 3 LEL.

Main Methods:

• The study included 10 patients diagnosed with stage 2 or 3 LEL and leg dermal backflow.
• A single lymphaticovenular anastomosis (LVA) was performed at the thigh using the superior-edge-of-the-knee incision.
• Intraoperative assessment of lymphatic vessels and flow direction, followed by postoperative evaluation of lymphedema volume reduction.

Main Results:

• The superior-edge-of-the-knee incision facilitated a single anastomosis in all patients, irrespective of LEL stage (stage 2 or 3).
• No instances of venous reflux were observed post-procedure.
• A mean reduction in the lower extremity lymphedema index of 20.160% was achieved after a mean follow-up of 7.70 months.

Conclusions:

• A single lymphaticovenular anastomosis (LVA) performed with the superior-edge-of-the-knee incision method demonstrates significant therapeutic potential.
• This surgical approach is effective for managing patients with stage 2 or 3 leg dermal backflow in lower extremity lymphedema.
• The method offers a promising solution for challenging LEL cases.