Department of Plastic Surgery and Reconstructive Surgery, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
Microsurgery. 2012 Oct;32(7):580-4. doi: 10.1002/micr.22022. Epub 2012 Aug 18.
In healthy people, no retrograde lymph flow occurs because of valves in collecting lymph vessels. However, in secondary lymphedema after lymph node dissection, lymph retention and lymphatic hypertension occurs and valvular dysfunction induces retrograde lymph flow. In this case reported, we focused on retrograde lymph flow and performed retrograde lymphatico-venous anastomosis (LVA) simultaneously with antegrade LVA. A 67-year-old Japanese woman had worsening edema in her right thigh and hip area for 3 years. She had previously undergone extended hysterectomy with lymph node dissection for endometrial cancer 8 years before. Indocyanine green test showed antegrade and retrograde lymph flow. Four LVAs were made in the right medial thigh and right lower abdominal area under local anesthesia. Lymphedema showed rapid improvement within 12 months and compression therapy was not required at 24 months after LVA. Retrograde LVA has a possibility of a more efficacy for secondary lymphedema.
在健康人群中，由于收集淋巴管中的瓣膜，不会发生逆行淋巴液流动。然而，在淋巴结清扫术后的继发性淋巴水肿中，淋巴液潴留和淋巴高压发生，瓣膜功能障碍导致逆行淋巴液流动。在本报告的病例中，我们专注于逆行淋巴液流动，并同时进行逆行淋巴静脉吻合术（LVA）和顺行 LVA。一名 67 岁日本女性，右大腿和臀部区域的水肿已经恶化了 3 年。她 8 年前因子宫内膜癌接受了广泛性子宫切除术和淋巴结清扫术。吲哚菁绿试验显示顺行和逆行淋巴液流动。在局部麻醉下，在右大腿内侧和右下腹部进行了 4 次 LVA。在 LVA 后 12 个月内，淋巴水肿迅速改善，24 个月后无需进行压迫治疗。逆行 LVA 对继发性淋巴水肿可能更有效。
