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]
