Huang G K, Hu R Q, Liu Z Z, Shen Y L, Lan T D, Pan G P
Plast Reconstr Surg. 1985 Nov;76(5):671-85.
Since 1980, 110 cases of lymphedema have been treated by microlymphaticovenous anastomosis. Of these 110 patients, 91 with obstructive lymphedema of lower limbs were reviewed. The immediate and long-term results have been very satisfactory. Excellent and good results were obtained in 79.1 percent. An average reduction in circumference of the affected limb of 6.4 cm and an average reduction of excess volume of 59.2 +/- 29.5 percent (representing 703 +/- 850 ml) were obtained. Subjective symptoms and objective signs were improved. Four patients (4.4 percent) showed poor results owing to severe fibrosis of neighboring tissue; no lymphatics could be located for anastomosis. As the authors gained experience with the operation over the last 3 years, they modified the operative procedure, the anastomotic technique, and the selection of collective lymphatics. The data obtained suggest that the quality of results is proportional to the number of anastomoses. In order to obtain the best results, the criteria for selection of patients and avoidance of postoperative relapse are discussed. Finally, a test for determination of the indications for microlymphatic surgery is described.
自1980年以来，110例淋巴水肿患者接受了显微淋巴管静脉吻合术治疗。在这110例患者中，对91例下肢阻塞性淋巴水肿患者进行了回顾性研究。近期和远期效果均非常令人满意。优良率达79.1%。患侧肢体周径平均缩小6.4 cm，多余体积平均减少59.2±29.5%（相当于703±850 ml）。主观症状和客观体征均得到改善。4例患者（4.4%）因邻近组织严重纤维化导致效果不佳；无法找到可供吻合的淋巴管。随着作者在过去3年中积累了手术经验，他们对手术操作、吻合技术以及集合淋巴管的选择进行了改进。所获得的数据表明，手术效果的质量与吻合口数量成正比。为了获得最佳效果，讨论了患者选择标准和避免术后复发的问题。最后，描述了一种确定显微淋巴手术适应证的试验。
