Microsurgical lymphovenous anastomosis for treatment of lymphedema: A critical review

Long-Term Results of Microscopic Lymphatic Vessel-Isolated Vein Anastomosis for Secondary Lymphedema of the Lower Extremities

“…Our clinical results were similar to those of others, 13,18,19 although they were inferior to those reported by Campisi's group. 11,16,17 This may be because we performed surgery on very selected patients whose lymphedema had proven intractable to nonoperative management, while excluding patients with very early stage lymphedema.…”

Surgical Management of Lymphedema: Past, Present, and Future

“…31 The few studies that have evaluated postoperative lymphangitis have found that lymphatic bypass procedures decreased the rate of this complication in most patients. 24,26,27,33,36 A few long-term studies (follow-up > 3 years) have shown that the improvements with bypass procedures are maintained even when garment use is discontinued. 27 Finally, most studies have reported improvements in subjective measures (i.e., sensation of heaviness, firmness, improved function, etc).…”

“…24,25,[27][28][29][30][33][34][35][36][37][38][39] Both primary and secondary forms of lymphedema have been treated successfully with lymphatic bypass procedures, although the efficacy of these procedures in primary lymphedema has been debated. 24,35 In addition, most series have reported better outcomes for upper extremities as compared with lower extremities.…”

“…33 Although it is logical that lymphedema would progress in at least some patients treated surgically, very few studies have reported worsening of lymphedema symptoms after surgery. 24,32,36 One recent technological advance in the lymphovenous bypass procedures has been the use of fluorescence lymphangiography for intraoperative mapping of lymphatic vessels. This technique enables surgeons to evaluate the severity of lymphedema and also to identify optimal anatomic locations to perform lymphovenous shunts in real time without making skin incisions.…”

Pneumatic Compression Improves Quality of Life in Patients with Lower-Extremity Lymphedema

“…Surgical approaches to treatment of lymphatic system that include excision, autologous lymphatic grafting and lymphovenous anastomoses, have been reported in patients with lower extremity lymphedema with mixed results showing short term reduction in limb girth and without reproducible long term success [5][6][7][8] .…”