Comparison of Lymphovenous Shunt Methods in a Rat Model: Supermicrosurgical Lymphaticovenular Anastomosis versus Microsurgical Lymphaticovenous Implantation

Plastic and Reconstructive Surgery - Tập 139 Số 6 - Trang 1407-1413 - 2017
Ryohei Ishiura1,2,3,4, Takumi Yamamoto5,1,2,3,4, Takahumi Saito1,2,3,4, Daisuke Mito1,2,3,4, Takuya Iida1,2,3,4
1Tokyo, Japan
2the Department of Plastic Surgery, Cancer Institute Ariake Hospital
3the Department of Plastic Surgery, Tokyo Metropolitan Bokutoh Hospital.
4the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo.
5Takumi Yamamoto, M.D., Ph.D., Department of Plastic Surgery, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130-0022, Japan, [email protected]

Tóm tắt

Background:

Lymphaticovenular anastomosis and lymphaticovenous implantation are the most popular lymphovenous shunt operations for the treatment of obstructive lymphedema. However, no study has been reported regarding direct comparison between lymphaticovenular anastomosis and lymphaticovenous implantation. This study aimed to compare postoperative patency of lymphaticovenular anastomosis and lymphaticovenous implantation using a rat model.

Methods:

Twelve Wistar rats were used for the study. The rats were randomized into the lymphaticovenular anastomosis group (n= 6) or the lymphaticovenous implantation group (n= 6). In the lymphaticovenular anastomosis group, the largest femoral lymphatic vessel was anastomosed to a similar-size vein in an end-to-end intima-to-intima coaptation manner, and the other lymphatics were ligated. In the lymphaticovenous implantation group, the femoral lymphatic vessel and surrounding tissue were inserted into the short saphenous vein with a telescopic anastomosis technique. Patency was evaluated intraoperatively and 1 week postoperatively with patent blue dye and indocyanine green lymphography.

Results:

The mean diameters of the lymphatic vessels and the veins were 0.242 mm (range, 0.20 to 0.35 mm) and 0.471 mm (range, 0.30 to 0.75 mm), respectively. Intraoperative patency was 100 percent (six of six) in both groups (p= 1.000). Postoperative patency was significantly higher in the lymphaticovenular anastomosis group compared with the lymphaticovenous implantation group [100 percent (six of six) versus 33.3 percent (two of six);p= 0.014]

Conclusion:

Postoperative patency of the lymphaticovenular anastomosis group was higher than that of the lymphaticovenous implantation group, although intraoperative patency rates of the lymphaticovenular anastomosis and lymphaticovenous implantation groups were comparable.

Từ khóa


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Plastic and Reconstructive Surgery

Tập 139 Số 6

1407-1413

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