Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion.

<h4>Objective</h4>The number of bypasses is the most important factor in lymphaticovenular anastomosis (LVA) for lymphedema treatment. Side-to-end (S-E) LVA, which can bypass bidirectional lymph flows via one anastomosis, is considered to be the most efficient bypass, but creation of lat...

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Autores principales:	Takumi Yamamoto, Hidehiko Yoshimatsu, Nana Yamamoto, Mitsunaga Narushima, Takuya Iida, Isao Koshima
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ea2b2272485940758af0d412d41a67bb
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spelling	oai:doaj.org-article:ea2b2272485940758af0d412d41a67bb2021-11-18T07:52:08ZSide-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion.1932-620310.1371/journal.pone.0059523https://doaj.org/article/ea2b2272485940758af0d412d41a67bb2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23536881/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>The number of bypasses is the most important factor in lymphaticovenular anastomosis (LVA) for lymphedema treatment. Side-to-end (S-E) LVA, which can bypass bidirectional lymph flows via one anastomosis, is considered to be the most efficient bypass, but creation of lateral window to a small lymphatic vessel is technically demanding. To overcome the difficulty, we introduced S-E anastomosis through temporary lymphatic expansion (SEATTLE) procedure in S-E LVA.<h4>Methods</h4>This was a retrospective observational study set in a teaching hospital. Forty eight lower extremity lymphedema (LEL) patients underwent LVA. S-E LVAs were performed with (SEATTLE group) or without (non-SEATTLE group) temporary lymphatic expansion. S-E LVAs were evaluated to compare anastomosis result in SEATTLE and non-SEATTLE groups.<h4>Results</h4>S-E LVAs resulted in 44 anastomoses in SEATTLE group (n = 25) and 37 anastomoses in non-SEATTLE group (n = 23). LEL index reduction in SEATTLE group was significantly greater than that in non-SEATTLE group (16.5±14.5 vs. 10.9±11.8, P = 0.041). Success rate of S-E LVA in SEATTLE group was significantly higher than that in non-SEATTLE group (95.5% vs 81.1%, P = 0.040). Thirty seven of 44 (84.1%) lymph vessels in SEATTLE group were successfully dilated by temporary lymphatic expansion maneuver. All of 9 failed S-E LVAs used a lymphatic vessel with diameter of 0.35 mm or smaller.<h4>Conclusions</h4>The SEATTLE procedure facilitates S-E LVA by a simple and easy maneuver. When the diameter of the lymphatic vessel is 0.35 mm or smaller even after the temporary lymphatic expansion maneuver, S-E LVA is not recommended due to relatively high failure rate.Takumi YamamotoHidehiko YoshimatsuNana YamamotoMitsunaga NarushimaTakuya IidaIsao KoshimaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e59523 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Takumi Yamamoto Hidehiko Yoshimatsu Nana Yamamoto Mitsunaga Narushima Takuya Iida Isao Koshima Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion.
description	<h4>Objective</h4>The number of bypasses is the most important factor in lymphaticovenular anastomosis (LVA) for lymphedema treatment. Side-to-end (S-E) LVA, which can bypass bidirectional lymph flows via one anastomosis, is considered to be the most efficient bypass, but creation of lateral window to a small lymphatic vessel is technically demanding. To overcome the difficulty, we introduced S-E anastomosis through temporary lymphatic expansion (SEATTLE) procedure in S-E LVA.<h4>Methods</h4>This was a retrospective observational study set in a teaching hospital. Forty eight lower extremity lymphedema (LEL) patients underwent LVA. S-E LVAs were performed with (SEATTLE group) or without (non-SEATTLE group) temporary lymphatic expansion. S-E LVAs were evaluated to compare anastomosis result in SEATTLE and non-SEATTLE groups.<h4>Results</h4>S-E LVAs resulted in 44 anastomoses in SEATTLE group (n = 25) and 37 anastomoses in non-SEATTLE group (n = 23). LEL index reduction in SEATTLE group was significantly greater than that in non-SEATTLE group (16.5±14.5 vs. 10.9±11.8, P = 0.041). Success rate of S-E LVA in SEATTLE group was significantly higher than that in non-SEATTLE group (95.5% vs 81.1%, P = 0.040). Thirty seven of 44 (84.1%) lymph vessels in SEATTLE group were successfully dilated by temporary lymphatic expansion maneuver. All of 9 failed S-E LVAs used a lymphatic vessel with diameter of 0.35 mm or smaller.<h4>Conclusions</h4>The SEATTLE procedure facilitates S-E LVA by a simple and easy maneuver. When the diameter of the lymphatic vessel is 0.35 mm or smaller even after the temporary lymphatic expansion maneuver, S-E LVA is not recommended due to relatively high failure rate.
format	article
author	Takumi Yamamoto Hidehiko Yoshimatsu Nana Yamamoto Mitsunaga Narushima Takuya Iida Isao Koshima
author_facet	Takumi Yamamoto Hidehiko Yoshimatsu Nana Yamamoto Mitsunaga Narushima Takuya Iida Isao Koshima
author_sort	Takumi Yamamoto
title	Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion.
title_short	Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion.
title_full	Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion.
title_fullStr	Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion.
title_full_unstemmed	Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion.
title_sort	side-to-end lymphaticovenular anastomosis through temporary lymphatic expansion.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/ea2b2272485940758af0d412d41a67bb
work_keys_str_mv	AT takumiyamamoto sidetoendlymphaticovenularanastomosisthroughtemporarylymphaticexpansion AT hidehikoyoshimatsu sidetoendlymphaticovenularanastomosisthroughtemporarylymphaticexpansion AT nanayamamoto sidetoendlymphaticovenularanastomosisthroughtemporarylymphaticexpansion AT mitsunaganarushima sidetoendlymphaticovenularanastomosisthroughtemporarylymphaticexpansion AT takuyaiida sidetoendlymphaticovenularanastomosisthroughtemporarylymphaticexpansion AT isaokoshima sidetoendlymphaticovenularanastomosisthroughtemporarylymphaticexpansion
_version_	1718422885340545024

Side-to-end Lymphaticovenular anastomosis through temporary lymphatic expansion.

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