研究者情報

カジカワ　アキヨシ   KAJIKAWA AKIYOSHI   梶川明義    所属   医学部医学科 形成外科学    職種   主任教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Single Lymphaticovenular Anastomosis for Early-Stage Lower Extremity Lymphedema Treated by the Superior-Edge-of-the-Knee Incision Method.
掲載誌名	正式名：Plast Reconstr Surg Glob Open
掲載区分	国外
巻・号・頁	26(6(2)),e1679頁
著者・共著者	◎Seki Y, Kajikawa A, Yamamoto T, Takeuchi T, Terashima T, Kurogi N.
担当区分	2nd著者
発行年月	2018/02
概要	Background: Surgical treatment of lower extremity lymphedema (LEL) remains challenging. Application of the superior-edge-of-the-knee incision method for lymphaticovenular anastomosis (LVA) is reported to have a strong therapeutic effect in patients with LEL because lymph-to-venous flow at the anastomosis is enhanced by knee joint movement during normal walking. We investigated whether a single LVA created by this method is adequate for early LEL. Methods: The study involved 10 patients with LEL characterized by stage 2 or 3 leg dermal backflow and treated by a single LVA at the thigh via the superior-edge-of-the-knee incision method. The lymphatic vessel and direction of flow were assessed intraoperatively, and reduction in lymphedema volume was assessed postoperatively. Results: Use of our incision method yielded a single anastomosis in all patients with stage 2 leg dermal backflow and in all patients with stage 3 leg dermal backflow. The lymphatic vessel was 0.65 ± 0.08 mm in diameter (0.65 ± 0.09 and 0.65 ± 0.09 mm, respectively; P = 1.000). No venous reflux occurred in any patient. Mean follow-up was 7.70 ± 3.30 months (9.60 ± 3.29 and 5.80 ± 2.17 months, respectively; P = 0.068). Mean reduction in the LEL index was 20.160 ± 9.892 (22.651 ± 12.272 and 17.668 ± 7.353, respectively; P = 0.462). Conclusion: A single LVA created by the superior-edge-of-the-knee incision method can be expected to have a strong therapeutic effect in patients with stage 2 or 3 leg dermal backflow.