Gentileschi Stefano, Servillo Maria, Salgarello Marzia
Department of Plastic and Reconstructive Surgery, Catholic University Sacred Heart, Policlinico Agostino Gemelli, Rome, Italy.
Microsurgery. 2015 Oct;35(7):565-8. doi: 10.1002/micr.22478. Epub 2015 Aug 28.
Postsurgical subcutaneous lymphocele is caused by accidental lesion of a lymphatic vessel that keeps on flowing lymph under the scar. Traditional treatments include aspiration and compression, with probable recurrence, and sclerotherapy which destroys both lymphatic cyst and vessel, creating risk of lymphedema. We describe the case of a postsurgical subcutaneous lymphocele of the left leg that was treated by supramicrosurgical lympatic-venous anastomosis. A single anastomosis was performed end-to-end, between one lymphatic vessel, individuated through indocyanine green lymphography, and one subcutaneous vein, distally to the lymphocele, under sedation and local anesthesia. Postoperative course was uneventful; the lymphocele completely resolved and never recurred during the nine months followup. This technique may heal the lymphocele with no impairing of lymph drainage function.
术后皮下淋巴囊肿是由淋巴管意外损伤引起的，淋巴管在瘢痕下持续引流淋巴液。传统治疗方法包括抽吸和压迫，可能会复发，还有硬化疗法，它会破坏淋巴囊肿和淋巴管，有导致淋巴水肿的风险。我们描述了一例左腿术后皮下淋巴囊肿的病例，该病例通过超显微淋巴管-静脉吻合术进行治疗。在镇静和局部麻醉下，通过吲哚菁绿淋巴造影确定一根淋巴管，并将其与淋巴囊肿远端的一根皮下静脉进行端对端的单一吻合。术后过程顺利；淋巴囊肿完全消退，在九个月的随访期间未复发。该技术可以治愈淋巴囊肿，而不会损害淋巴引流功能。
