背景:淋巴静脉吻合术(LVA)是一种用于治疗淋巴水肿的微创外科手术。该外科手术将浅表淋巴管吻合到附近的静脉以建立淋巴-静脉通路。淋巴外科医生在进行淋巴静脉吻合术时遇到的最常见挑战之一是静脉和淋巴管的大小不匹配以及受技术限制的有效性。我们进行了一项初步研究,以评估重叠锁定吻合术(OLA)LVA技术在解决上述问题方面的可行性。
方法:在这个坚固的,我们提出了一种新的LVAOLA技术,解决了传统技术的挑战,2022年9月至2023年3月期间,10例淋巴水肿患者用于OLA和E-E吻合术。时间吻合,方法吻合,和通畅率,在这项研究中评估了淋巴水肿的体积。
结果:我们在10例患者的123个LVA中使用OLA技术进行了44个LVA,ICG成像显示引流通畅。有一例轻微的液体泄漏,这是通过加强缝合线解决的。OLA的平均吻合时间为5.55分钟,而E-E的平均吻合时间为12.1分钟。病人的伤口愈合,没有感染,主观肢围减少。
结论:OLA技术可以作为当前LVA技术的有价值的补充,特别是对于淋巴管和静脉大小不匹配的情况。该技术有可能促进LVA在淋巴水肿的治疗和预防中的广泛应用。
BACKGROUND: Lymphaticovenular anastomosis (LVA) is a minimally invasive surgical procedure used to treat lymphedema. This surgical procedure connects the superficial lymphatic vessels to nearby veins to establish lymphatic-venous pathways. One of the most common challenges encountered by lymphatic surgeons when performing LVA is a mismatch in the sizes of the veins and lymphatic vessels, with the effectiveness limited by technical constraints. We conducted a pilot study to evaluate the feasibility of an overlapping lockup anastomosis (OLA) LVA technique to address these problems.
METHODS: In this study, we present a novel OLA technique for LVA that addresses the challenges with conventional techniques. The OLA technique was used in 10 lymphedema patients between September 2022 and March 2023 to compare OLA and end-to-end anastomosis. The time required for anastomosis, method of anastomosis, patency rates, and lymphedema volume were evaluated in this study.
RESULTS: Of 123 LVAs, 44 were performed using the OLA technique in 10 patients, with indocyanine green lymphangiography revealing unobstructed drainage. A single case of slight fluid leakage occurred, which was resolved by reinforcing the sutures. The average anastomosis time for OLA and the end-to-end technique was 5.55 minutes and 12.1 minutes, respectively. The wounds of the patients healed without infection, and the subjective limb circumference decreased.
CONCLUSIONS: The OLA technique could serve as a valuable addition to the current LVA technique, especially for cases with a mismatch in the sizes of the lymphatic vessels and veins. This technique has the potential to promote the broader application of LVA in the treatment and prevention of lymphedema.