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Reconstructive microsurgery of lymph vessels: The personal method of lymphatic‐venous‐lymphatic (LVL) interpositioned grafted shunt
Author(s) -
Campisi C.,
Boccardo F.,
Tacchella M.
Publication year - 1995
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.1920160309
Subject(s) - medicine , lymphatic system , lymphedema , anastomosis , microsurgery , shunting , lymph , surgery , lymphatic vessel , lymph duct , pathology , cancer , thoracic duct , breast cancer , metastasis
Our clinical observations in 64 patients affected by chronic obstructive lymphedema (either arm or leg) undergoing interposition autologous lymphatic‐venous‐lymphatic (LVL) anastomoses are reported. This microsurgical technique is an alternative to other lymphatic shunting methods, especially when venous dysfunction coexists in the same limb and, therefore, when direct lymphatic‐venous anastomosis is accordingly inadequate. Preoperative diagnostic evaluation (including lymphatic and venous isotopic scintigraphy, Doppler venous flowmetrics, and pressure manometry) plays an essential role in assessing the conditions of both the lymphatic and venous systems and in establishing which microsurgical procedure, if any, is indicated. Our microsurgical technique consists of inserting suitably large and lengthy autologous venous grafts between lymphatic collectors above and below the site of obstruction to lymph flow. The data show that, using this technique, both limb function and edema improved, and in all patients followed up for over 5 years edema regression was permanent. © 1995 Wiley‐Liss, Inc.