Campisi C, Boccardo F, Tacchella M
Department of Emergency Surgery, University of Genoa, Italy.
Microsurgery. 1995;16(3):161-6. doi: 10.1002/micr.1920160309.
Our clinical observations in 64 patients affected by chronic obstructive lymphedema (either arm or leg) undergoing interposition autologous lymphatic-venous-lymphatic (LVL) anastomoses are reported. This microsurgical technique is an alternative to other lymphatic shunting methods, especially when venous dysfunction coexists in the same limb and, therefore, when direct lymphatic-venous anastomosis is accordingly inadequate. Preoperative diagnostic evaluation (including lymphatic and venous isotopic scintigraphy, Doppler venous flowmetrics, and pressure manometry) plays an essential role in assessing the conditions of both the lymphatic and venous systems and in establishing which microsurgical procedure, if any, is indicated. Our microsurgical technique consists of inserting suitably large and lengthy autologous venous grafts between lymphatic collectors above and below the site of obstruction to lymph flow. The data show that, using this technique, both limb function and edema improved, and in all patients followed up for over 5 years edema regression was permanent.
本文报告了64例慢性阻塞性淋巴水肿（累及手臂或腿部）患者接受自体淋巴管-静脉-淋巴管（LVL）搭桥吻合术的临床观察结果。这种显微外科技术是其他淋巴分流方法的替代方案，尤其是当同一肢体同时存在静脉功能障碍，因此直接淋巴管-静脉吻合术不适用时。术前诊断评估（包括淋巴管和静脉同位素闪烁扫描、多普勒静脉血流测量和压力测量）在评估淋巴和静脉系统状况以及确定是否需要进行显微外科手术（如有）方面起着至关重要的作用。我们的显微外科技术包括在淋巴流阻塞部位上方和下方的淋巴管收集器之间插入适当大且长的自体静脉移植物。数据显示，使用该技术后，肢体功能和水肿均得到改善，并且所有随访超过5年的患者水肿消退是永久性的。
