Long term outcomes from lymphatic venous anastomosis after total hysterectomy to prevent postoperative lymphedema in lower limb

Ezawa, Masahiro; Sasaki, Hiroshi; Yamada, Kyosuke; Takano, Hirokuni; Iwasaka, Tsuyoshi; Nakao, Yasuo; Yokochi, Tomoki; Okamoto, Aikou

doi:10.1186/s12893-019-0628-z

Cited by 9 publications

(4 citation statements)

References 25 publications

(26 reference statements)

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“…However, because these factors caused mild and temporary damage of the skin barrier, they did not seem to be the risk factors for erysipelas relapse [ 10 ]. Surgery can change the local tissue structure and cause poor lymphatic reflux [ p < 0.0001, OR 4.1 (95% CI 2.4–7.1)] [ 11 ]. The results of univariate analysis further indicated that surgery was not the only risk factor for erysipelas, but there were other risk factors as well.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of recurrent erysipelas in adult Chinese patients: a prospective cohort study

Wang

et al. 2021

BMC Infect Dis

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Background Erysipelas is a common skin infection that is prone to recur. Recurrent erysipelas has a severe effect on the quality of life of patients. The present study aimed to investigate the risk factors of recurrent erysipelas in adult Chinese patients. Methods A total of 428 Chinese patients with erysipelas who met the inclusion criteria were studied. The patients were divided into the nonrecurrent erysipelas group and the recurrent erysipelas group. Clinical data were collected on the first episode and relapse of erysipelas. The patients were followed up every 3 months. Statistical analysis was performed to analyze and determine the risk factors of erysipelas relapse. Results Univariate analysis was performed to analyze the data, including surgery, types of antibiotics administered in the first episode, obesity, diabetes mellitus, venous insufficiency, lymphedema, and malignancy. The differences between the groups were statistically significant (p < 0.05). The Cox proportional hazards regression model analysis showed that the final risk factors included surgery, obesity, diabetes mellitus, venous insufficiency, and lymphedema. Conclusions Surgery, obesity, diabetes mellitus, venous insufficiency, and lymphedema are considered as risk factors for recurrent erysipelas.

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Section: Discussionmentioning

confidence: 99%

Risk factors of recurrent erysipelas in adult Chinese patients: a prospective cohort study

Wang

et al. 2021

BMC Infect Dis

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“…1 ). 5 14 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 An overview of each study is summarized in Supplementary Table S2 (available online only). Ten and six single-arm studies reporting outcomes of PLS for upper ( Supplementary Table S3 ; available online only) and lower ( Supplementary Table S4 ; available online only) extremity CRL were included, respectively.…”

Section: Resultsmentioning

confidence: 99%

Primary Prevention of Cancer-Related Lymphedema Using Preventive Lymphatic Surgery: Systematic Review and Meta-analysis

Ciudad

Escandón

Bustos

et al. 2022

Indian J Plast Surg

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Background Several studies have proven prophylactic lymphovenous anastomosis (LVA) performed after lymphadenectomy can potentially reduce the risk of cancer-related lymphedema (CRL) without compromising the oncological treatment. We present a systematic review of the current evidence on the primary prevention of CRL using preventive lymphatic surgery (PLS). Patients and Methods A comprehensive search across PubMed, Cochrane-EBMR, Web of Science, Ovid Medline (R) and in-process, SCOPUS, and ScienceDirect was performed through December 2020. A meta-analysis with a random-effect method was accomplished. Results Twenty-four studies including 1547 patients fulfilled the inclusion criteria. Overall, 830 prophylactic LVA procedures were performed after oncological treatment, of which 61 developed lymphedema.The pooled cumulative rate of upper extremity lymphedema after axillary lymph node dissection (ALND) and PLS was 5.15% (95% CI, 2.9%–7.5%; p < 0.01). The pooled cumulative rate of lower extremity lymphedema after oncological surgical treatment and PLS was 6.66% (95% CI < 1–13.4%, p-value = 0.5). Pooled analysis showed that PLS reduced the incidence of upper and lower limb lymphedema after lymph node dissection by 18.7 per 100 patients treated (risk difference [RD] – 18.7%, 95% CI – 29.5% to – 7.9%; p < 0.001) and by 30.3 per 100 patients treated (RD – 30.3%, 95% CI – 46.5% to – 14%; p < 0.001), respectively, versus no prophylactic lymphatic reconstruction. Conclusions Low-quality studies and a high risk of bias halt the formulating of strong recommendations in favor of PLS, despite preliminary reports theoretically indicating that the inclusion of PLS may significantly decrease the incidence of CRL.

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“…ILR is commonly performed for BCRL primary prevention, which is known as Lymphatic Microsurgical Preventive Healing Approach (LYMPHA) (boccardo 1,2,3,4). Several studies have also applied ILR for primary lymphedema prevention in the lower extremity (Ezawa et al, 2019; Wagner et al, 2022; Wan et al, 2022). However, the surgical concept can also be served for secondary prevention.…”

Section: Discussionmentioning

confidence: 99%

Immediate‐delayed lymphatic reconstruction after axillary lymph nodes dissection for locally advanced breast cancer‐related lymphedema prevention: Report of two cases

et al. 2023

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Approximately 60%–70% of breast cancer patients in Indonesia are diagnosed in the locally advanced stage. The stage carries a higher risk of lymph node metastasis which increases susceptibility to lymph obstruction. Hence, breast cancer‐related lymphedema (BCRL) could present before axillary lymph node dissection (ALND). The purpose of this case report is to describe immediate‐delayed lymphatic reconstructions with lymphaticovenous anastomosis in two subclinical lymphedema cases that present before ALND. There were 51 and 58 years old breast cancer patients with stage IIIC and IIIB, respectively. Both had no arm lymphedema symptoms, but arm lymphatic vessel abnormalities were found during preoperative indocyanine green (ICG) lymphography. Mastectomy and ALND were performed and proceeded with lymphaticovenous anastomoses (LVA) in both cases. One LVA at the axilla (isotopic) was done in the first patient. On the second patient, 3 LVAs at the affected arm (ectopic) and 3 isotopic LVAs were created. The patients were discharged on the second day without complications during the follow‐up. The intensity of dermal backflow was reduced, and no subclinical lymphedema progression occurred during 11 and 9 months follow‐up, respectively. Based on these cases, BCRL screening might be recommended for the locally advanced stage before cancer treatment. Once diagnosed, immediate lymphatic reconstruction after ALND should be recommended to cure or prevent BCRL progression.

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Long term outcomes from lymphatic venous anastomosis after total hysterectomy to prevent postoperative lymphedema in lower limb

Cited by 9 publications

References 25 publications

Risk factors of recurrent erysipelas in adult Chinese patients: a prospective cohort study

Risk factors of recurrent erysipelas in adult Chinese patients: a prospective cohort study

Primary Prevention of Cancer-Related Lymphedema Using Preventive Lymphatic Surgery: Systematic Review and Meta-analysis

Immediate‐delayed lymphatic reconstruction after axillary lymph nodes dissection for locally advanced breast cancer‐related lymphedema prevention: Report of two cases

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