Campisi C, Boccardo F, Zilli A, Macciò A, Napoli F, et al.
Microsurgery. Date of publication 2001 Jan 1;volume 21(4):135-9.
1. Microsurgery. 2001;21(4):135-9.
Long-term results after lymphatic-venous anastomoses for the treatment of
obstructive lymphedema.
Campisi C(1), Boccardo F, Zilli A, Macciò A, Napoli F.
Author information:
(1)Department of Specialistic Surgical Sciences, Anaesthesiology and Organ
Transplants (DISCAT), Emergency Surgical Clinic Section, Lymphology and
Microsurgery Center, S. Martino Hospital, University of Genoa, 16122 Genoa,
Italy. campisi@unige.it
Over the past 25 years, 665 patients with obstructive lymphedema have been
treated with microsurgical lymphatic-venous anastomoses; of these, 446 patients
were available for long-term follow-up study. Objective assessment was undertaken
by water volumetry and lymphoscintigraphy. Lymphangioscintigraphy,
lymphangiography (in patients with gravitational reflux pathology), and
echo-Doppler were used preoperatively. Subjective improvement was noted in 578
patients (87%). Objectively, volume changes showed a significant improvement in
552 patients (83%), with an average reduction of 67% of the excess volume. Of
those patients followed up, 379 patients (85%) have been able to discontinue the
use of conservative measures, with an average follow-up of more than 7 years and
average reduction in excess volume of 69%. There was a 87% reduction in the
incidence of cellulitis after microsurgery. In those patients who improved,
drainage resulted in increased softness of the limbs. Peripheral edema (hand and
foot) diminished considerably in most patients. These long-term results indicate
that lymphatic-venous anastomoses have a place in the treatment of obstructive
lymphedema and should be the therapy of choice in patients who are not
sufficiently responsive to nonsurgical treatment. Improved results can be
expected with earlier operations because patients referred earlier usually have
fewer lymphatic alterations.
PMID: 11494379 [Indexed for MEDLINE]
