Francesco Boccardo1, Mario Valenzano2, Sergio Costantini2, Federico Casabona2, Matteo Morotti2, Paolo Sala2, Franco De Cian3, Lidia Molinari4, Stefano Spinaci4, Sara Dessalvi4, Corrado Cesare Campisi4, Giuseppe Villa5, Corradino Campisi4. 1. Unit of Lymphatic Surgery, Department of Surgery, IRCCS S. Martino Hospital - IST, National Cancer Institute for Cancer Research, University of Genoa, Genova, Italy. francesco.boccardo@unige.it. 2. Department of Obstetrics and Gynecology, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy. 3. Unit of Oncologic Surgery, Department of Surgery, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy. 4. Unit of Lymphatic Surgery, Department of Surgery, IRCCS S. Martino Hospital - IST, National Cancer Institute for Cancer Research, University of Genoa, Genova, Italy. 5. Unit of Nuclear Medicine, Department of Surgery, S. Martino Hospital, National Cancer Institute, University of Genoa, Genova, Italy.
Abstract
BACKGROUND: Inguinofemoral lymphadenectomy carries a high risk of lower limb lymphedema. This report describes the feasibility of performing multiple lymphatic-venous anastomoses (MLVA) after inguinofemoral lymph node completion (LYMPHA technique) and the possible benefit of LYMPHA for preventing lymphedema. METHODS: Between February, 2011 and October, 2014, 11 patients with vulvar cancer and 16 patients with melanoma of the trunk requiring inguinofemoral lymphadenectomy underwent lymph node dissection and the LYMPHA technique. Blue dye was injected into the thigh 10 min before surgery. Lymphatics afferent to the blue nodes were used to perform MLVA using a collateral branch of the great saphenous vein. RESULTS: The mean age of patients in the vulvar cancer group was 52 years (range, 48-75 years). The melanoma group comprised seven men and nine women with a mean age of 41 years (range, 37-56 years). Of the 16 patients, 5 with vulvar cancer underwent bilateral inguinofemoral lymphadenectomy, whereas the remaining 6 patients with vulvar cancer and all 16 patients with melanoma of the trunk had unilateral node dissection. All the patients were treated by the LYMPHA technique. No lymphocele or infectious complications occurred. Transient lower-extremity edema occurred for one melanoma patient (6.25 %), which resolved after 2 months, and permanent lower-extremity edema occurred for one patient (9 %) with vulvar cancer. CONCLUSIONS: The LYMPHA technique appears to be feasible, safe, and effective for the prevention of lower limb lymphedema, thereby improving the patient's quality of life and decreasing health care costs.
BACKGROUND: Inguinofemoral lymphadenectomy carries a high risk of lower limb lymphedema. This report describes the feasibility of performing multiple lymphatic-venous anastomoses (MLVA) after inguinofemoral lymph node completion (LYMPHA technique) and the possible benefit of LYMPHA for preventing lymphedema. METHODS: Between February, 2011 and October, 2014, 11 patients with vulvar cancer and 16 patients with melanoma of the trunk requiring inguinofemoral lymphadenectomy underwent lymph node dissection and the LYMPHA technique. Blue dye was injected into the thigh 10 min before surgery. Lymphatics afferent to the blue nodes were used to perform MLVA using a collateral branch of the great saphenous vein. RESULTS: The mean age of patients in the vulvar cancer group was 52 years (range, 48-75 years). The melanoma group comprised seven men and nine women with a mean age of 41 years (range, 37-56 years). Of the 16 patients, 5 with vulvar cancer underwent bilateral inguinofemoral lymphadenectomy, whereas the remaining 6 patients with vulvar cancer and all 16 patients with melanoma of the trunk had unilateral node dissection. All the patients were treated by the LYMPHA technique. No lymphocele or infectious complications occurred. Transient lower-extremity edema occurred for one melanomapatient (6.25 %), which resolved after 2 months, and permanent lower-extremity edema occurred for one patient (9 %) with vulvar cancer. CONCLUSIONS: The LYMPHA technique appears to be feasible, safe, and effective for the prevention of lower limb lymphedema, thereby improving the patient's quality of life and decreasing health care costs.
Authors: Iqbal Sarif; Khaled Elsayad; Daniel Rolf; Christopher Kittel; Georg Gosheger; Eva Wardelmann; Uwe Haverkamp; Hans Theodor Eich Journal: Cancers (Basel) Date: 2021-04-27 Impact factor: 6.639
Authors: Christian D Fankhauser; Esther W C Lee; Allaudin Issa; Pedro Oliveira; Maurice Lau; Vijay Sangar; Arie Parnham Journal: Eur Urol Open Sci Date: 2021-11-18
Authors: Peter Dall; Thomas Hildebrandt; Andreas du Bois; Eric Boetel; Janine Ahlfaenger; Matthias W Beckmann; Mareike Bommert Journal: Arch Gynecol Obstet Date: 2020-04-18 Impact factor: 2.344
Authors: Elisa Francone; Simona Reina; Francesco Spagnolo; Lorenzo Di Maira; Ferdinando Cafiero; Nicola Solari Journal: Int J Med Robot Date: 2022-03-17 Impact factor: 2.483