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Surgical Treatment of Upper Extremity Lymphedema: Early Results Using Lymphovenous Bypass

M. Asher Schusterman II, MD Carolyn De La Cruz, MD
UPMC
2016-01-31

Presenter: M. Asher Schusterman II, MD

Affidavit:
This is the original work of the resident and his mentor.

Director Name: Joseph Losee

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction

Background: Lymphedema remains a significant cause of morbidity for patients worldwide. A more recently popular, yet not well studied, surgical option is lymphovenous (LV) bypass. We report our early results using this technique.

Methods: Retrospective chart review was done for all patients who underwent LV bypass at our center. Exclusion criteria were follow-up of less than 3 months or incomplete medical records. Primary data-points included limb volume measurements and number of anastomoses. Volume measurements were calculated using sequential circumference measurements taken preoperatively and at 1 and 3 months postoperatively. Postop volume measurements were compared to preoperative measurements and the number of anastomoses was compared to overall improvement.

Results: 10 patients met our criteria (average age 60 years). All patients had lymphedema secondary to surgery. Average OR time was 6.5 hours and the average number of anastomoses was 3.3 (range 2-5). All but one patient reported a subjective improvement. On average, excess volume of the disease limb decreased 44.2% at 1 month at 36.1% at 3 months. At 3 months postop, the number of anastomoses showed significant positive correlation to improvement (p = 0.035).

Conclusions: Our early results using LV bypass show both quantitative and qualitative improvement. Furthermore, the number of anastomoses showed a positive correlation to improvement of excess volume. Further studies and follow-up are required to establish long-lasting results.

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