کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4117119 1270293 2016 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Complete lymph flow reconstruction: A free vascularized lymph node true perforator flap transfer with efferent lymphaticolymphatic anastomosis
ترجمه فارسی عنوان
بازسازی جریان لنفاوی کامل: یک گره لنفاوی عروقی مجزا، انتقال فلاپ سوراخ کننده پروتئینی با آناستوموز لنفاوی پلیمفات مایع
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری های گوش و جراحی پلاستیک صورت
چکیده انگلیسی

SummaryTreatment of primary lower extremity lymphedema (LEL) is challenging, and lymph node transfer (LNT) can be a choice of treatment for progressive LEL. However, LNT has a risk of donor site lymphedema and possible lymph node (LN) sclerosis due to efferent lymphatic vessel (ELV) obstruction. Here, we report the first case of complete lymph flow reconstruction with true perforator LNT with efferent lymphaticolymphatic anastomosis (ELLA) for a patient with primary LEL and severe lymphosclerosis. A 49-year-old female suffered from primary progressive unilateral left LEL refractory to conservative treatments with frequent episodes of cellulitis. A true perforator LN flap was selectively harvested from the left lateral thoracic region under indocyanine green (ICG) lymphography navigation and transferred to the left groin with perforator-to-perforator anastomosis. The ELV of the transplanted LN was supermicrosurgically anastomosed to the contralateral iliac lymphatic vessel that was subcutaneously transferred to the left groin. Postoperatively, the patient experienced no episode of cellulitis with reduced degree of compression treatment, and lymphedematous volume decreased from 306 to 264 in terms of LEL index. Postoperative ICG lymphography showed evidence of reconstructed lymph flow from the left foot to the left groin and to the right inguinal LN through the transplanted LN flap and the ELLA. There were no subjective or objective findings of donor site lymphedema of the left arm or the right back and the lower extremity. True perforator LN flap with ELLA is a safe and effective treatment and has the potential to be a useful therapeutic option for primary unilateral LEL.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Plastic, Reconstructive & Aesthetic Surgery - Volume 69, Issue 9, September 2016, Pages 1227–1233
نویسندگان
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