Takeishi Meisei, Kojima Masahiro, Mori Katuya, Kurihara Kunihiro, Sasaki Hiroshi
Department of Plastic and Reconstructive Surgery , Jikei University School of Medicine, Minatoku Tokyo, Japan.
Ann Plast Surg. 2006 Sep;57(3):300-4. doi: 10.1097/01.sap.0000222727.05869.04.
Lymphedema of lower extremities occurs following surgical resection of malignant tumors and intrapelvic lymph node dissection and is a long-term problem for patients. We performed primary intrapelvic lymphaticovenular anastomosis to prevent postoperative leg lymphedema. The procedures were conducted in 7 patients (aged 35-61 years) with cancer of the uterine body. After completion of hystero-oophorectomy and intrapelvic lymph node dissection, the afferent lymphatics entering internal and external iliac lymph nodes were end-to-end anastomosed with branches of the deep inferior epigastric veins. The time taken for constructing 4 anastomoses was 100 to 120 minutes. The follow-up period ranged from 10 to 18 months (mean, 14 months). All patients were discharged and are independent in daily living. Apart from mild leg lymphedema in 1 patient, no lymphedema was observed in other patients up to the last follow-up. This surgical modality is effective in preventing lymphedema in lower extremities after intrapelvic para-aortic lymph node dissection.
下肢淋巴水肿发生于恶性肿瘤手术切除及盆腔内淋巴结清扫术后，是患者面临的一个长期问题。我们进行了原发性盆腔内淋巴管静脉吻合术以预防术后腿部淋巴水肿。该手术在7例（年龄35 - 61岁）子宫体癌患者中实施。在子宫卵巢切除及盆腔内淋巴结清扫完成后，将汇入髂内和髂外淋巴结的输入淋巴管与腹壁下深静脉分支进行端端吻合。构建4个吻合口所需时间为100至120分钟。随访期为10至18个月（平均14个月）。所有患者均已出院且日常生活自理。直至最后一次随访，除1例患者有轻度腿部淋巴水肿外，其他患者均未观察到淋巴水肿。这种手术方式对于预防盆腔内腹主动脉旁淋巴结清扫术后下肢淋巴水肿是有效的。
