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      A case of inguinal lymphaticovenular anastomosis for refractory lymphatic ascites after uterine cancer surgery

      case-report

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          Abstract

          We herein report a case of refractory lymphatic ascites after uterine cancer surgery treated with bilateral inguinal lymphaticovenular anastomosis (LVA). LVA was performed four months after the uterine cancer surgery in a patient with refractory ascites that had developed one month after the gynecologic surgery. One year and eight months after LVA, there was no recurrence of ascites accumulation.

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          Supermicrosurgical lymphaticovenular anastomosis for the treatment of lymphedema in the upper extremities.

          K Urushibara, I Koshima, T Moriguchi … (2000)
          Over the last eight years, the authors analyzed obstructive lymphedema of a unilateral upper extremity in a total of 27 females, comparing the use of supramicrosurgical lymphaticovenule anastomoses and/or conservative treatment. The most common cause of edema was mastectomy, with or without subsequent radiation therapy for breast cancer. As an objective assessment of the extent of edema, the circumferences of the affected and opposite normal forearms were measured at 10 cm below the olecranon of the arm. Twelve of these patients received continual bandaging. In these patients, the average excess circumference of the affected arm was 6.4 cm over that of the normal forearm; the average duration of edema before treatment was 3.5 years; the average period for conservative treatment was 10.6 months; and the average decrease in circumference was 0.8 cm (11.7 percent of the preoperative excess). Twelve patients underwent surgery and postoperative continual bandaging. In these patients, the average excess circumference was 8.9 cm; the average duration of edema before surgery was 8.2 years; the average follow-up after surgery was 2.2 years; and the average decrease in circumference was 4.1 cm (47.3 percent of the preoperative excess). These results indicated that supermicrolymphaticovenular anastomoses with postoperative bandaging have a valuable place in the treatment of obstructive lymphedema.
          Article 0 comments Cited 82 times – based on 0 reviews     Review now
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            The diagnosis and management of postoperative chylous ascites.

            Ilan Leibovitch, Yoram Mor, Jacob Golomb … (2002)
            Postoperative chylous ascites is a rare complication of retroperitoneal and mediastinal surgery that represents a difficult management problem due to the serious mechanical, nutritional and immunological consequences of the constant loss of protein and lymphocytes. We reviewed the topic of postoperative chylous ascites with special emphasis on the relevant diagnostic and imaging modalities. We propose a novel management algorithm. We performed a MEDLINE search of the literature on chylous ascites using chyloperitoneum as the subject heading and chylous ascites as an additional key word. The search yielded 651 articles. We focused on 102 series, collective reviews and mainly case reports related to the issue of postoperative chylous ascites. We propose a novel algorithm based on a step-up approach aimed at promoting decreased lymph production and flow as well as maintaining nutritional balance. The management algorithm integrates repeat palliative paracentesis, dietary measures, total parenteral nutrition therapy, peritoneovenous shunting and surgical closure of the lymphoperitoneal fistula. Due to the remarkable effectiveness of somatostatin therapy for the closure of lymphatic fistula somatostatin therapy should be attempted with or without total parenteral nutrition early in the course of treatment of chylous ascites before any invasive steps are taken. Various management modalities may be used successfully to treat chylous ascites. Therefore, treatment should be individualized and adjusted to the severity of lymphatic leakage and its consequences. The outcome mostly depends on the underlying pathological condition. Thus, in the absence of malignant or congenital underlying pathology the prognosis in cases of postoperative chylous ascites is good with the majority responding to conservative measures.
            Article 0 comments Cited 73 times – based on 0 reviews     Review now
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              The effectiveness of lymphangiography as a treatment method for various chyle leakages.

              R Yoshimatsu, Marc T. Nishimura, T Masunami … (2009)
              The purpose of this study was to assess the effectiveness of lymphangiography as a treatment for various chyle leakages. Pedal lymphangiography was performed in 9 patients (6 men and 3 women; mean age, 59 years) who were unlikely to be cured only by conservative treatment - a low-fat medium-chain triglyceride diet, total parenteral nutrition and insertion of a drainage tube - and in whom chylothorax (n = 5), chylous ascites (n = 2) and lymphatic fistulae (n = 2) were refractory to conservative treatment. In 7 of these 9 patients (78%), we could detect the chyle leakage sites. In 8 of the 9 patients (89%), lymphatic leakage was stopped after lymphangiography, and surgical re-intervention was avoided. No cases had a recurrence of chyle leakage during follow-up (range, 1-54 months). Lymphangiography is effective not only for diagnosis but also as treatment for various chyle leakages. Early lymphangiography is therefore recommended for patients with chyle leakages who are unlikely to be cured by conservative treatment only.
              Article 0 comments Cited 58 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Case Reports Plast Surg Hand Surg
                Journal ID (iso-abbrev): Case Reports Plast Surg Hand Surg
                Title: Case Reports in Plastic Surgery & Hand Surgery
                Publisher: Taylor & Francis
                ISSN (Electronic): 2332-0885
                Publication date (Electronic, pub): 18 January 2024
                Publication date (Electronic, collection): 2024
                Publication date PMC-release: 18 January 2024
                Volume: 11
                Issue: 1
                Electronic Location Identifier: 2304617
                Affiliations
                [a ]Department of Plastic and Reconstructive Surgery, Nagasaki University Hospital , Nagasaki, Japan
                [b ]Department of Obstetrics and Gynecology, Nagasaki University Hospital , Nagasaki, Japan
                Author notes
                CONTACT Atsuhiko Iwao a-iwao@ 123456nagasaki-u.ac.jp Department of Plastic and Reconstructive Surgery, Nagasaki University Hospital , 1-7-1 Sakamoto, Nagasaki, 8518501, Japan
                Article
                Publisher ID: 2304617
                DOI: 10.1080/23320885.2024.2304617
                PMC ID: 10798289
                SO-VID: 96bba147-a4ca-4e42-9687-61e1195351b8
                Copyright © © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

                History
                Page count
                Figures: 3, Tables: 0, Pages: 5, Words: 1951
                Categories
                Subject: Case Report
                Subject: Case Report

                Keywords: inguinal lymphaticovenular anastomosis,refractory lymphatic ascites,uterine cancer,pelvic lympha­denectomy,para-aortic lymphadenectomy
                Data availability:
                Keywords: inguinal lymphaticovenular anastomosis, refractory lymphatic ascites, uterine cancer, pelvic lympha­denectomy, para-aortic lymphadenectomy

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