Canders Caleb P, Nguyen Phuong D, Festekjian Jaco H, Rudkin George H
Divisions of Emergency Medicine, UCLA Medical Center, Los Angeles, Calif.
Plastic and Reconstructive Surgery, UCLA Medical Center, Los Angeles, Calif.
Eplasty. 2013 Nov 7;13:e57. eCollection 2013.
Lower extremity lymphoceles secondary to saphenous vein grafting are exceptionally rare and there is only 1 previously reported case in the English literature. Data on treatment of lower extremity lymphoceles are limited and based on studies of groin lymphoceles. We discuss operative resection with selective ligation of feeding lymphatic vessels as a treatment option of lower extremity lymphoceles.
A 64-year-old man who had undergone coronary artery bypass grafting 6 years prior presented with a left lower extremity mass at the site where his saphenous vein had been harvested. Examination demonstrated a 12-cm, mobile, nonpulsatile mass at his medial left calf. The findings of magnetic resonance imaging were consistent with a lymphocele.
Intraoperative injection of isosulfan blue dye was used to identify feeding lymphatic vessels and the lymphocele cavity was excised. Leg drains were discontinued after 3 days, and the patient was discharged home after 6 days.
Operative resection with isosulfan blue dye lymphatic mapping and selective ligation of lymphatic vessels is a viable treatment of lower extremity lymphoceles.
大隐静脉移植术后继发的下肢淋巴管瘤极为罕见，英文文献中此前仅报道过1例。关于下肢淋巴管瘤治疗的数据有限，且基于腹股沟淋巴管瘤的研究。我们讨论手术切除并选择性结扎供血淋巴管作为下肢淋巴管瘤的一种治疗选择。
一名64岁男性，6年前接受了冠状动脉旁路移植术，在其大隐静脉取材部位出现左下肢肿块。检查发现左小腿内侧有一个12厘米、可活动、无搏动的肿块。磁共振成像结果与淋巴管瘤相符。
术中注射异硫蓝染料以识别供血淋巴管，并切除淋巴管瘤腔。3天后停止腿部引流，6天后患者出院回家。
采用异硫蓝染料淋巴管造影和选择性结扎淋巴管进行手术切除是治疗下肢淋巴管瘤的一种可行方法。
