Lee Jayoung, Kim Soojin, Woo Kyongje, Bae Hasuk
Department of Rehabilitation Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Department of Plastic and Reconstructive Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
Ann Rehabil Med. 2022 Aug;46(4):202-208. doi: 10.5535/arm.22063. Epub 2022 Aug 31.
To analyze the effects of lymphovenous anastomosis (LVA) surgery after 1 year using the elastic index (EI) and volume.
This study was a retrospective study of 41 patients, with lymphedema, who underwent LVA surgery between July 2018 and June 2020. Limb circumference, used to determine the volume of the limb with lymphedema, and EI, which reflects tissue stiffness and measured using ultrasonography were measured for each patient before and 1 year after LVA surgery. To examine the effect of LVA, differences in the preoperative and 1-year postoperative volumes and EIs were analyzed using the Wilcoxon signed-rank test.
The mean volume and EI of the dominant site in upper-extremity lymphedema were 2,309.4 cm3 and 1.4, respectively, preoperatively and 2,237.1 cm3 and 0.9, respectively, at 1 year postoperatively. The mean volume and EI difference of the dominant site 1 year after surgery was -16.6 cm3 (p=0.22) and -0.5 (p<0.001). The mean volume and EI of dominant site in lower-extremity lymphedema were 6,137.0 cm3 and 1.2, respectively, preoperatively, and 5,832.6 cm3 and 1.1, respectively, at 1 year postoperatively. The mean volume and EI difference of the dominant site 1 year postoperatively were -320.9 cm3 (p=0.04) and -0.2 (p=0.09), respectively.
LVA surgery is more effective in reducing pressure than in reducing volume, which may be helpful in preventing the progression of lymphedema.
使用弹性指数（EI）和体积分析淋巴管静脉吻合术（LVA）术后1年的效果。
本研究是一项对41例淋巴水肿患者的回顾性研究，这些患者于2018年7月至2020年6月接受了LVA手术。在LVA手术前及术后1年，测量每位患者用于确定淋巴水肿肢体体积的肢体周长，以及使用超声测量的反映组织硬度的EI。为了检查LVA的效果，使用Wilcoxon符号秩检验分析术前和术后1年体积及EI的差异。
上肢淋巴水肿优势部位的平均体积和EI术前分别为2309.4 cm³和1.4，术后1年分别为2237.1 cm³和0.9。术后1年优势部位的平均体积和EI差异分别为-16.6 cm³（p = 0.22）和-0.5（p < 0.001）。下肢淋巴水肿优势部位的平均体积和EI术前分别为6137.0 cm³和1.2，术后1年分别为5832.6 cm³和1.1。术后1年优势部位的平均体积和EI差异分别为-320.9 cm³（p = 0.04）和-0.2（p = 0.09）。
LVA手术在降低压力方面比在减少体积方面更有效，这可能有助于预防淋巴水肿的进展。
