Nagase Takashi, Gonda Koichi, Inoue Keita, Higashino Takuya, Fukuda Norio, Gorai Katsuya, Mihara Makoto, Nakanishi Misa, Koshima Isao
Department of Plastic and Reconstructive Surgery, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Tokyo 113-8655, Japan.
Int J Clin Oncol. 2005 Oct;10(5):304-10. doi: 10.1007/s10147-005-0518-5.
Although lymphedema in the extremities is a troublesome adverse effect following radical resection of various cancers, conventional therapies for lymphedema are not always satisfactory, and new breakthroughs are anticipated. With the introduction of supermicrosurgical techniques for the anastomosis of blood or lymphatic vessels less than 0.8 mm in diameter, we have developed a novel method of lymphaticovenular anastomosis for the treatment of primary as well as secondary lymphedema in the extremities. Here, we review the pathophysiological aspects of lymphedema, emphasizing the importance of smooth-muscle cell function in the affected lymphatic walls. We then describe the theoretical basis and detailed operative techniques of our lymphaticovenular anastomoses. Although technically demanding, especially for beginners, we believe that this method will become a new clinical standard for the treatment of lymphedema in the near future.
尽管肢体淋巴水肿是各种癌症根治性切除术后令人困扰的不良反应，但传统的淋巴水肿治疗方法并不总是令人满意，人们期待新的突破。随着用于直径小于0.8毫米的血管或淋巴管吻合的超显微外科技术的引入，我们开发了一种用于治疗肢体原发性和继发性淋巴水肿的新型淋巴管静脉吻合方法。在此，我们回顾淋巴水肿的病理生理方面，强调受影响淋巴管壁中平滑肌细胞功能的重要性。然后我们描述了我们的淋巴管静脉吻合术的理论基础和详细手术技术。尽管技术要求高，尤其是对初学者而言，但我们相信这种方法在不久的将来将成为治疗淋巴水肿的新临床标准。
