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Boccardo F, Valenzano M, Costantini S, Casabona F, Morotti M, Sala P, De Cian F, Molinari L, Spinaci S, Dessalvi S, Campisi CC, Villa G, Campisi C, et al.
Annals of surgical oncology. Date of publication 2016 Oct 1;volume 23(11):3558-3563.
1. Ann Surg Oncol. 2016 Oct;23(11):3558-3563. doi: 10.1245/s10434-016-5282-4. Epub 2016 May 24. LYMPHA Technique to Prevent Secondary Lower Limb Lymphedema. Boccardo F(1), Valenzano M(2), Costantini S(2), Casabona F(2), Morotti M(2), Sala P(2), De Cian F(3), Molinari L(4), Spinaci S(4), Dessalvi S(4), Campisi CC(4), Villa G(5), Campisi C(4). Author information: (1)Unit of Lymphatic Surgery, Department of Surgery, IRCCS S. Martino Hospital - IST, National Cancer Institute for Cancer Research, University of Genoa, Genova, Italy. francesco.boccardo@unige.it. (2)Department of Obstetrics and Gynecology, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy. (3)Unit of Oncologic Surgery, Department of Surgery, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy. (4)Unit of Lymphatic Surgery, Department of Surgery, IRCCS S. Martino Hospital - IST, National Cancer Institute for Cancer Research, University of Genoa, Genova, Italy. (5)Unit of Nuclear Medicine, Department of Surgery, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy. BACKGROUND: Inguinofemoral lymphadenectomy carries a high risk of lower limb lymphedema. This report describes the feasibility of performing multiple lymphatic-venous anastomoses (MLVA) after inguinofemoral lymph node completion (LYMPHA technique) and the possible benefit of LYMPHA for preventing lymphedema. METHODS: Between February, 2011 and October, 2014, 11 patients with vulvar cancer and 16 patients with melanoma of the trunk requiring inguinofemoral lymphadenectomy underwent lymph node dissection and the LYMPHA technique. Blue dye was injected into the thigh 10 min before surgery. Lymphatics afferent to the blue nodes were used to perform MLVA using a collateral branch of the great saphenous vein. RESULTS: The mean age of patients in the vulvar cancer group was 52 years (range, 48-75 years). The melanoma group comprised seven men and nine women with a mean age of 41 years (range, 37-56 years). Of the 16 patients, 5 with vulvar cancer underwent bilateral inguinofemoral lymphadenectomy, whereas the remaining 6 patients with vulvar cancer and all 16 patients with melanoma of the trunk had unilateral node dissection. All the patients were treated by the LYMPHA technique. No lymphocele or infectious complications occurred. Transient lower-extremity edema occurred for one melanoma patient (6.25 %), which resolved after 2 months, and permanent lower-extremity edema occurred for one patient (9 %) with vulvar cancer. CONCLUSIONS: The LYMPHA technique appears to be feasible, safe, and effective for the prevention of lower limb lymphedema, thereby improving the patient's quality of life and decreasing health care costs. DOI: 10.1245/s10434-016-5282-4 PMID: 27221358 [Indexed for MEDLINE]
Appears in following Topics:
Lymphedema - Treatment and Emerging Strategies for Prevention