Clinical Effectiveness of Lymphaticovenular Anastomosis for Secondary Extremity Lymphedema

  Objective  To investigate the clinical effectiveness of lymphaticovenular anastomosis in secondary extremity lymphedema.

  Methods  Fifteen patients with secondary extremity lymphedema treated with lymphaticovenular anastomosis between September 2013 and August 2014 at Peking Union Medical College Hospital were included in this study, of whom 12 were unilateral, and 3 were bilateral. Indocyanine green lymphography was used before the operation to evaluate the severity of lymphedema and the patency of lymphatic vessels. Microsurgery was applied to determine the site and number of anastomosis. The circumference of the involved limb was measured before and after the operation at the same level to calculate the reduction of circumference.

  Results  Lymphaticovenular anastomosis was successfully conducted in all the 15 patients. The follow-up period ranged from 6 to 10 months (mean 8.3 months), and the average circumference reductions in upper and lower limbs were 33.7% and 20.0%, respectively. None of the patients suffered recurrent lymphangitis after the operation.

  Conclusion  Lymphaticovenular anastomosis is an effective treatment for early pitting extremity lymphedema, especially for the cases with patent lymphatic vessels without fibrosis as confirmed by preoperative lymphography.