Surgical Prevention of Breast Cancer-Related Lymphedema: Delayed Distal Lymphaticovenicular Anastomosis– An Alternative to the Classic LYMPHA Technique

Breast cancer-related lymphedema (BCRL) is a devastating potential complication of axillary lymphadenectomy and radiotherapy. Several effective surgical treatment measures now exist, including lymphaticovenicular anastomosis (LVA), vascularized lymph node transplant (VLNT), and vascularized lymph v...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Lynn M Orfahli, Tony CT Huang, Wei F Chen
Formato:	article
Lenguaje:	EN
Publicado:	Kaviani Breast Disease Institute 2021
Materias:	lymphedema supermicrosurgery lymphaticovenicular anastomosis immediate lymphatic reconstruction distal delayed LVA Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/ca2bd9aba33d415a89432aecb721a2ec
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:ca2bd9aba33d415a89432aecb721a2ec
record_format	dspace
spelling	oai:doaj.org-article:ca2bd9aba33d415a89432aecb721a2ec2021-12-04T02:18:53ZSurgical Prevention of Breast Cancer-Related Lymphedema: Delayed Distal Lymphaticovenicular Anastomosis– An Alternative to the Classic LYMPHA Technique10.32768/abc.202184277-2832383-0433https://doaj.org/article/ca2bd9aba33d415a89432aecb721a2ec2021-10-01T00:00:00Zhttps://www.archbreastcancer.com/index.php/abc/article/view/431https://doaj.org/toc/2383-0433 Breast cancer-related lymphedema (BCRL) is a devastating potential complication of axillary lymphadenectomy and radiotherapy. Several effective surgical treatment measures now exist, including lymphaticovenicular anastomosis (LVA), vascularized lymph node transplant (VLNT), and vascularized lymph vessel transplant (VLVT) for fluid-predominant disease, and liposuction and radical excision for solid-predominant disease. Super-microsurgical LVA is of particular interest, owing to its minimally invasive nature and highly favorable outcomes in the hands of experienced supermicrosurgeons. As LVA techniques are refined and improved, interest is rising in utilizing it to prevent the manifestation of disease in the first place. Lymphatic microsurgical preventive healing approach (LYMPHA), also known as immediate lymphatic reconstruction (ILR), is the most widely used approach. It involves performing axillary LVA immediately following axillary lymphadenectomy. While preliminary results are favorable, the high-pressure proximal axillary venous branches used in ILR and the site’s vulnerability to damage from radiotherapy endanger the long-term patency of these anastomoses. Moreover, a theoretical oncologic concern exists regarding creating a direct conduit for the remaining malignant cells in the axilla into the circulation. Finally, coordinating ILR with axillary lymphadenectomy creates significant logistical challenges. Delayed, distally-based LVA (DD-LVA) has emerged as an alternative method that avoids these issues. This article presents an overview of the development of preemptive lymphatic reconstruction, and the senior author’s approach to the novel technique of DD-LVA. Lynn M OrfahliTony CT HuangWei F ChenKaviani Breast Disease Institutearticlelymphedemasupermicrosurgerylymphaticovenicular anastomosisimmediate lymphatic reconstructiondistal delayed LVANeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENArchives of Breast Cancer (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	lymphedema supermicrosurgery lymphaticovenicular anastomosis immediate lymphatic reconstruction distal delayed LVA Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	lymphedema supermicrosurgery lymphaticovenicular anastomosis immediate lymphatic reconstruction distal delayed LVA Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Lynn M Orfahli Tony CT Huang Wei F Chen Surgical Prevention of Breast Cancer-Related Lymphedema: Delayed Distal Lymphaticovenicular Anastomosis– An Alternative to the Classic LYMPHA Technique
description	Breast cancer-related lymphedema (BCRL) is a devastating potential complication of axillary lymphadenectomy and radiotherapy. Several effective surgical treatment measures now exist, including lymphaticovenicular anastomosis (LVA), vascularized lymph node transplant (VLNT), and vascularized lymph vessel transplant (VLVT) for fluid-predominant disease, and liposuction and radical excision for solid-predominant disease. Super-microsurgical LVA is of particular interest, owing to its minimally invasive nature and highly favorable outcomes in the hands of experienced supermicrosurgeons. As LVA techniques are refined and improved, interest is rising in utilizing it to prevent the manifestation of disease in the first place. Lymphatic microsurgical preventive healing approach (LYMPHA), also known as immediate lymphatic reconstruction (ILR), is the most widely used approach. It involves performing axillary LVA immediately following axillary lymphadenectomy. While preliminary results are favorable, the high-pressure proximal axillary venous branches used in ILR and the site’s vulnerability to damage from radiotherapy endanger the long-term patency of these anastomoses. Moreover, a theoretical oncologic concern exists regarding creating a direct conduit for the remaining malignant cells in the axilla into the circulation. Finally, coordinating ILR with axillary lymphadenectomy creates significant logistical challenges. Delayed, distally-based LVA (DD-LVA) has emerged as an alternative method that avoids these issues. This article presents an overview of the development of preemptive lymphatic reconstruction, and the senior author’s approach to the novel technique of DD-LVA.
format	article
author	Lynn M Orfahli Tony CT Huang Wei F Chen
author_facet	Lynn M Orfahli Tony CT Huang Wei F Chen
author_sort	Lynn M Orfahli
title	Surgical Prevention of Breast Cancer-Related Lymphedema: Delayed Distal Lymphaticovenicular Anastomosis– An Alternative to the Classic LYMPHA Technique
title_short	Surgical Prevention of Breast Cancer-Related Lymphedema: Delayed Distal Lymphaticovenicular Anastomosis– An Alternative to the Classic LYMPHA Technique
title_full	Surgical Prevention of Breast Cancer-Related Lymphedema: Delayed Distal Lymphaticovenicular Anastomosis– An Alternative to the Classic LYMPHA Technique
title_fullStr	Surgical Prevention of Breast Cancer-Related Lymphedema: Delayed Distal Lymphaticovenicular Anastomosis– An Alternative to the Classic LYMPHA Technique
title_full_unstemmed	Surgical Prevention of Breast Cancer-Related Lymphedema: Delayed Distal Lymphaticovenicular Anastomosis– An Alternative to the Classic LYMPHA Technique
title_sort	surgical prevention of breast cancer-related lymphedema: delayed distal lymphaticovenicular anastomosis– an alternative to the classic lympha technique
publisher	Kaviani Breast Disease Institute
publishDate	2021
url	https://doaj.org/article/ca2bd9aba33d415a89432aecb721a2ec
work_keys_str_mv	AT lynnmorfahli surgicalpreventionofbreastcancerrelatedlymphedemadelayeddistallymphaticovenicularanastomosisanalternativetotheclassiclymphatechnique AT tonycthuang surgicalpreventionofbreastcancerrelatedlymphedemadelayeddistallymphaticovenicularanastomosisanalternativetotheclassiclymphatechnique AT weifchen surgicalpreventionofbreastcancerrelatedlymphedemadelayeddistallymphaticovenicularanastomosisanalternativetotheclassiclymphatechnique
_version_	1718373055957303296

Surgical Prevention of Breast Cancer-Related Lymphedema: Delayed Distal Lymphaticovenicular Anastomosis– An Alternative to the Classic LYMPHA Technique

Ejemplares similares