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Ann Vasc Surg. 2014 Oct;28(7):1798.e1-6. doi: 10.1016/j.avsg.2014.06.005. Epub 2014 Jun 12.

Case report: a new hybrid surgical approach for treating mosaic pattern secondary lymphedema in the lower extremities.

Author information

1
Department of Vascular Surgery, Saiseikai Kawaguchi General Hospital, Saitama, Japan. Electronic address: mihara.plasticsurgery@gmail.com.
2
Undergraduate of Medicine, The University of Tokyo, Tokyo, Japan.
3
Department of Vascular Surgery, Saiseikai Kawaguchi General Hospital, Saitama, Japan; Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan.
4
Department of Health Communication, The University of Tokyo, Tokyo, Japan.

Abstract

Two of the most common surgical lymph reconstructive interventions for the treatment of secondary lymphedema today are lymphaticovenous anastomosis (LVA) and lymph node transplant. However, neither of these approaches has proven enough evidence to be considered as an effective treatment measure. In this case report, we will introduce a "hybrid method" where combinations of these two conventional methods are used in treating a 52-year-old female patient who displays a mosaic pattern of aggravating secondary lymphedema. Preoperative indocyanine green lymphography assessment was used to identify the different stages of lymphedema within the symptomatic limbs. The application of the hybrid method has resulted in a faster improvement in limb circumference and tissue tenderness compared with when only LVA is performed and has resulted in successful recovery from lymphedema in our case. The hybrid method allows surgeons to select the most appropriate surgical approach for each region displaying a different severity staging of lymphedema, establishing a new order-made remedy for chronic secondary lymphedema patients.

PMID:
24930976
DOI:
10.1016/j.avsg.2014.06.005
[Indexed for MEDLINE]

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