Abstract:
BACKGROUND:Traditionally, lymphovenous anastomosis is not routinely performed in patients with advanced stage lymphedema because of difficulty with identifying functioning lymphatics. This study presents the use of duplex ultrasound and magnetic resonance lymphangiography to identify functional lymphatics and reports the clinical outcome of lymphovenous anastomosis in advanced stage lower extremity lymphedema patients. METHODS:This was a retrospective study of 42 patients (50 lower limbs) with advanced lymphedema (late stage 2 or 3) that underwent functional lymphovenous anastomoses. Functional lymphatic vessels were identified preoperatively using magnetic resonance lymphangiography and duplex ultrasound. RESULTS:An average of 4.64 lymphovenous anastomoses were performed per limb using the lymphatics located in the deep fat underneath the superficial fascia. The average diameter of lymphatic vessels was 0.61 mm (range, 0.35 to 1 mm). The average limb volume was reduced 14.0 percent postoperatively, followed by 15.2 percent after 3 months, and 15.5 percent after 6 months and 1 year (p < 0.001). For patients with unilateral lymphedema, 32.4 percent had less than 10 percent volume excess compared to the contralateral side postoperatively, whereas 20.5 percent had more than 20 percent volume excess. The incidence of cellulitis decreased from 0.84 per year to 0.07 per year after surgery (p < 0.001). CONCLUSION:This study shows that functioning lymphatic vessels can be identified preoperatively using ultrasound and magnetic resonance lymphangiography; thus, lymphovenous anastomoses can effectively reduce the volume of the limb and improve subjective symptoms in patients with advanced stage lymphedema of the lower extremity. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Cha HG,Oh TM,Cho MJ,Pak CSJ,Suh HP,Jeon JY,Hong JPdoi
10.1097/PRS.0000000000007507subject
Has Abstractpub_date
2021-01-01 00:00:00pages
199-207issue
1eissn
0032-1052issn
1529-4242pii
00006534-202101000-00038journal_volume
147pub_type
杂志文章abstract::Xeroradiography, because of its unique phenomenon of "edge enhancement," has some advantages for assessing facial fractures. In 17 of the 19 patients in our pilot study group, this technique was as valuable as, or more so than, plain films. The xerogram done prior to laminagraphy is a useful "map" for the radiologist ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197808000-00008
更新日期:1978-08-01 00:00:00
abstract:BACKGROUND:Abdominal donor-site flaps, including the transverse rectus abdominis musculocutaneous (TRAM) and deep inferior epigastric artery (DIEA) perforator flaps, are standard in autologous breast reconstruction. With significant variation in the vascular anatomy of the abdominal wall, preoperative imaging is essent...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000293874.71269.c9
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The treatment of lentigo maligna and lentigo maligna melanoma presents a difficult problem for clinicians. Published guidelines recommend a 5-mm excision margin for lentigo maligna and a 1-cm margin for lentigo maligna melanoma, yet these are often inadequate. The authors' purpose is to report their 10-year ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181bcf002
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Conventional palatoplasty relies on extensive mucosal incisions and isolation of flaps on the palatine vessels to facilitate midline closure and velar reconstruction. This introduces substantial scarring, which has adverse effects on vascularity and growth. The authors have developed a minimally invasive pal...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000280
更新日期:2014-07-01 00:00:00
abstract::The viability of axial pattern skin flaps in pigs was assessed by the use of intravenous fluorescein, intradermal injection of 133Xe in saline, intravenous 51Cr tagged red cells, and angiography. The results were correlated with flap survival at 4 days postoperatively. Intravenous fluorescein provided the most accurat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197902000-00016
更新日期:1979-02-01 00:00:00
abstract::The columella is a significant factor in the aesthetic balance of the nose, particularly the lower one-third of the nose. Its position is dependent on the anatomical constituents of the columella, and neighboring anatomical structures. Six components of the hanging columella have been identified: the caudal septum, me...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003569
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Severe orbital soft-tissue loss and contracted eye sockets often present in patients who have had enucleation, exenteration, or other ocular diseases. In this article, the authors report a novel contracted eye socket reconstruction technique using lateral upper arm free flaps and review the surgical outcome ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000133
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Therapies to improve outcomes following peripheral nerve injury are lacking. Prolonged denervation of muscle and Schwann cells contributes to poor outcomes. In this study, the authors assess the effects of growth hormone therapy on axonal regeneration, Schwann cell and muscle maintenance, and end-organ reinn...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002188
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Lipofilling is a treatment modality to restore tissue volume, but it may also rejuvenate the aging skin. Platelet-rich plasma has been reported to augment the efficacy of lipofilling, both on graft take and rejuvenation, by altering the adipose-derived stem cells. The authors hypothesized that addition of pl...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/PRS.0000000000004081
更新日期:2018-02-01 00:00:00
abstract::This study was designed to test the hypothesis that demineralized perforated bone matrix implant from canine skull and tibia induces new bone formation within the calvarial defect comparable with the bone induced by autogenous graft. We also were interested in determining whether demineralized perforated bone matrix i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199509001-00002
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Carpal tunnel release is one of the most common procedures in hand surgery. There is only scarce evidence regarding whether platelet inhibitors increase the risk of developing postoperative hemorrhage in carpal tunnel release. METHODS:This is a multicenter, propensity score-matched study including 635 carpa...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/PRS.0000000000006465
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:MicroRNAs (miRNAs) are small noncoding RNA molecules that regulate gene expression in the progress of proliferation, differentiation, and apoptosis. A keloid is considered to be a type of benign tumor. The exact contribution of miRNAs in keloid fibroblasts remains largely unknown. METHODS:Loss and gain of f...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000577
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to demonstrate the impact of bilateral free flap breast reconstruction on the abdominal wall. This is the second installation of a two-part series. Presented here are bilateral combinations of three techniques: the muscle-sparing free transverse rectus abdominis musculocutaneous...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181ea42ed
更新日期:2010-11-01 00:00:00
abstract::We present the first case of complete hemithoracic reconstruction of an irradiated postpneumonectomy recurrent empyema cavity that was unresponsive to multiple conventional treatments. The procedure described used a chain-link of two coupled free flaps consisting of an omental and TRAM flap. A single abdominal donor s...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200001000-00032
更新日期:2000-01-01 00:00:00
abstract::Cerebrospinal fluid rhinorrhea, whatever the etiology, is a serious and life-threatening problem. We present a case following rhinoplasty. To our knowledge, this specific complication has not been reported, most likely because it has gone unrecognized, since most cerebrospinal fluid leaks cease spontaneously. Surgeons...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198301000-00025
更新日期:1983-01-01 00:00:00
abstract:BACKGROUND:Tracking world cases of breast implant-associated anaplastic large cell lymphoma (ALCL) is currently limited to patient registries at a few academic centers, dependent upon patient referral and case reports in the literature. The purpose of this study was to review and compare federal database adverse event ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003233
更新日期:2017-05-01 00:00:00
abstract::Treatment options for the craniosynostoses vary from conservative observation until completion of growth to radical remodeling in infancy. To further define the timing and type of treatment necessary in these complex disorders, we have retrospectively analyzed all patients operated on for this deformity during the pas...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract::The roots of the working hours mandate and controversy are outlined, the effect on resident education is described, and the service versus education equation is defined. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182450c27
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:In late presentation of brachial plexus trauma, it is unclear whether donor nerves should be devoted to nerve reconstruction or reserved for free functional muscle transfer. The authors systematically reviewed recovery of elbow flexion after nerve reconstruction versus free functional muscle transfer for lat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000004229
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Understanding and optimizing psychosocial functioning in children with craniofacial anomalies are essential components of their reconstructive care. This work compared parental perceptions to pediatric self-reported psychosocial functioning in children with craniofacial anomalies. METHODS:Two hundred twenty...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006388
更新日期:2020-01-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200005000-00018
更新日期:2000-05-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000764
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:An acellular dermal matrix will typically incorporate, in time, with the overlying mastectomy skin flap. This remodeling process may be adversely impacted in patients who require chemotherapy and radiation, which influence neovascularization and cellular proliferation. METHODS:Multiple biopsy specimens were...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000807
更新日期:2015-01-01 00:00:00
abstract::The authors present their latest development of a strictly vertical retroauricular incision to minimize a sequela of a face lift, namely, a visible scar. The temporal preauricular vertical incision and the retroauricular vertical incision form two parallel arms of a U-shaped incision. Anteriorly, a downward rotation f...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200206000-00058
更新日期:2002-06-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198604000-00004
更新日期:1986-04-01 00:00:00
abstract::The supraperiosteal-subSMAS lifting technique, which has been performed since 1985, for the rejuvenation of the upper two-thirds of the face is described, and the results obtained in a series of 128 cases treated, emphasizing the attainment of an effective rejuvenation together with a minimum of complications and unde...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199811000-00059
更新日期:1998-11-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000750
更新日期:2014-12-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318221dc2a
更新日期:2011-09-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Optogenetics is an emerging technology that enables the expression of light-activated ion channels in mammalian cells. Neurons expressing light-activated ion channels can be depolarized using the appropriate wavelength of light. Optical stimulation of neurons could have important implications for further und...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002460
更新日期:2016-09-01 00:00:00