Informace o publikaci

Comparison of contraction-type and noncontraction-type lymphatic vessels in lymphaticovenous anastomosis for cancer-related unilateral lower limb lymphedema: a retrospective cohort propensity-score-matched outcome analysis

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KNOZ Martin WANG Yu-Ming LUO Sheng-Dean WU Shao-Chun LIN Wei-Che TSAI Pei-Yu CHIEN Peng-Chen HSIEH Ching-Hua YANG Johnson Chia-Shen

Rok publikování 2024
Druh Článek v odborném periodiku
Časopis / Zdroj INTERNATIONAL JOURNAL OF SURGERY
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://journals.lww.com/international-journal-of-surgery/fulltext/2024/04000/comparison_of_contraction_type_and.5.aspx
Doi http://dx.doi.org/10.1097/JS9.0000000000001106
Klíčová slova contraction-type; lymphatic vessels; lymphaticovenous anastomosis; lymphedema; NECST classification; noncontraction type; supermicrosurgery
Popis Background:Contraction-type lymphatic vessels (LV) are considered suboptimal for lymphaticovenous anastomosis (LVA). However, despite these pathological changes, their functionality and link to outcomes have not been fully elucidated. The aim of this study was to determine the impact on outcomes when contraction-type LVs were used for LVA compared to the noncontraction-type (normal + ectatic) counterpart for treating lower limb lymphedema. Study design:Eighty-three patients with gynecologic cancer-related unilateral lower-limb lymphedema who underwent LVA as their primary treatment were enrolled in this study. The study group included 20 patients who used only contraction-type LVs. An additional 63 patients (control group) received noncontraction-type LVs only. Patients with a history of LVA, liposuction, or excisional therapy were excluded. Patient characteristics, intraoperative findings, functional parameters, and pre-LVA and post-LVA volume changes were recorded and matched using propensity scores. The primary endpoint was the volume change at 6/12 months after LVA. Results:After matching, 20 patients were included in each group. All parameters were matched, except that the study group still had a significantly inferior indocyanine green (ICG)-positive ratio, lymph flow-positive ratio, and washout-positive ratios (P<0.001, P=0.003, and P<0.001, respectively) when compared to the control group after matching. However, at 1-year follow-up, the postoperative percentage volume reduction was comparable between the groups (P=0.619). Conclusion:The use of contraction-type LVs for LVA is encouraged when no other LVs are available.

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