Utilizing a lower extremity vein graft for immediate lymphatic reconstruction.
J Plast Reconstr Aesthet Surg
; 75(8): 2831-2870, 2022 08.
Article
en En
| MEDLINE
| ID: mdl-35821010
ABSTRACT
Immediate lymphatic reconstruction (ILR) is targeted at preventing breast cancer related lymphedema (BCRL) by anastomosing disrupted arm lymphatic channels to axillary vein tributaries. Inadequate vein length and venous back-bleeding are two technical reasons that lead to ILR procedures being aborted intraoperatively. Recently, our team began routinely harvesting a lower extremity vein graft (LEVG) for all ILR procedures to reduce our abort rate. We describe the surgical approach of an LEVG and evaluate the effects on aborted case rates and intraoperative time. A retrospective review of our institutional lymphatic database was conducted. Two hundred and forty-seven breast cancer patients were taken to the operating room for attempted ILR in the past 5 years. Prior to the use of an LEVG (n = 205), our abort rate was 14%. Since routinely performing an LEVG with ILR (n = 42), we have not aborted a single case. Despite an LEVG requiring one additional anastomosis to connect the vein graft to the native axillary vein tributary, this technique has not changed the intraoperative time for ILR procedures. In this technical contribution, we describe our early experience performing immediate lymphatic reconstruction utilizing a lower extremity vein graft. Implementation of this technique appears to have promising effects on aborted case rates without affecting intraoperative time, and greatly facilitates the lymphovenous anastomosis.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Vasos Linfáticos
/
Linfedema del Cáncer de Mama
/
Linfedema
Tipo de estudio:
Etiology_studies
Límite:
Humans
Idioma:
En
Revista:
J Plast Reconstr Aesthet Surg
Año:
2022
Tipo del documento:
Article
País de afiliación:
Estados Unidos