Lee Christina Dami, Kwiecien Grzegorz, Wenzinger Eric J, Lee Irene, Cakmakoglu Cagri, Schwarz Graham S
Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Microsurgery. 2023 Jan;43(1):63-67. doi: 10.1002/micr.30859. Epub 2022 Jan 11.
Lymphovenous anastomosis (LVA) represents an alternative treatment for retroperitoneal lymphangiectasia. In contrast to sclerotherapy or excision, which may risk lymphatic obstruction and subsequent lymphedema, LVA preserves existing lymphatic architecture and transit. This report shows long-term efficacy of LVA for functional decompression of a symptomatic pathologically dilatated retroperitoneal lymphatics. A 47-year-old female with retroperitoneal lymphangiectasia refractory to multiple percutaneous drainages and treatments with sclerosing agents underwent LVA with anastomosis of a dominant segment of retroperitoneal lymphangiectasia to the deep inferior epigastric vein. Postoperative serial magnetic resonance imaging with 3-dimensional volume calculation over the 27 months follow-up showed evidence of decompression of the lesion with patent bypass. There were no known immediate complications nor requirement of further interventions. The patient's subjective pain also decreased substantially. This report confirms long-term efficacy of LVA for retroperitoneal lymphangiectasia as an alternative to sclerotherapy and surgical excision in the setting of previously failed treatments.
淋巴静脉吻合术（LVA）是治疗腹膜后淋巴管扩张症的一种替代疗法。与硬化疗法或切除术不同，硬化疗法或切除术可能会有淋巴梗阻及随后发生淋巴水肿的风险，而LVA可保留现有的淋巴结构和淋巴引流。本报告展示了LVA对有症状的病理性扩张腹膜后淋巴管进行功能减压的长期疗效。一名47岁女性，腹膜后淋巴管扩张症经多次经皮引流及硬化剂治疗均无效，接受了LVA，即将腹膜后淋巴管扩张症的一个主要节段与腹壁下深静脉进行吻合。术后在27个月的随访期间进行的系列磁共振成像及三维容积计算显示，病变减压且旁路通畅。无已知的即刻并发症，也无需进一步干预。患者的主观疼痛也大幅减轻。本报告证实了LVA对腹膜后淋巴管扩张症的长期疗效，在先前治疗失败的情况下，可作为硬化疗法和手术切除的替代方法。
