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Article

Distally Prophylactic Lymphaticovenular Anastomoses after Axillary or Inguinal Complete Lymph Node Dissection Followed by Radiotherapy: A Case Series

1
Department of Medicine, Surgery and Neuroscience, Division of Plastic and Reconstructive Surgery, “Santa Maria alle Scotte” Hospital, University of Siena, 53100 Siena, Italy
2
Department of Plastic Surgery, ASST Spedali Civili di Brescia, 25121 Brescia, Italy
3
Operative Unit of Reconstructive Microsurgery, Department of Surgery, ASST Valle Camonica, 25040 Brescia, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Mauro Salvatore Alessandro Alaibac
Medicina 2022, 58(2), 207; https://doi.org/10.3390/medicina58020207
Received: 11 November 2021 / Revised: 29 December 2021 / Accepted: 28 January 2022 / Published: 29 January 2022
Background and Objectives: Lymphedema is an important and underestimated condition, and this progressive chronic disease has serious implications on patients’ quality of life. The main goal of research would be to prevent lymphedema, instead of curing it. Patients receiving radiotherapy after lymph node dissection have a significantly higher risk of developing lymphedema. Through the prophylactic use of microsurgical lymphaticovenular anastomoses in selected patients, we could prevent the development of lymphedema. Materials and Methods: Six patients who underwent prophylactic lymphaticovenular anastomoses in a distal site to the axillary or groin region after axillary or inguinal complete lymph node dissection followed by radiotherapy were analyzed. Patients characteristics, comorbidities, operative details, postoperative complications and follow-up assessments were recorded. Results: Neither early nor late generic surgical complications were reported. We observed no lymphedema development throughout the post-surgical follow-up. In particular, we observed no increase in limb diameter measured at 1, 3, 6 and 12 months postoperatively. Conclusion: In our experience, performing LVA after axillary or groin lymphadenectomy and after adjuvant radiotherapy, and distally to the irradiated area, allows us to ensure the long-term patency of anastomoses in order to obtain the best results in terms of reducing the risk of iatrogenic lymphedema. This preliminary report is encouraging, and the adoption of our approach should be considered in selected patients. View Full-Text
Keywords: lymphedema; ICG lymphography; lymphatic surgery; preventive lymphaticovenular anastomosis; supermicrosurgery lymphedema; ICG lymphography; lymphatic surgery; preventive lymphaticovenular anastomosis; supermicrosurgery
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MDPI and ACS Style

Pierazzi, D.M.; Arleo, S.; Faini, G. Distally Prophylactic Lymphaticovenular Anastomoses after Axillary or Inguinal Complete Lymph Node Dissection Followed by Radiotherapy: A Case Series. Medicina 2022, 58, 207. https://doi.org/10.3390/medicina58020207

AMA Style

Pierazzi DM, Arleo S, Faini G. Distally Prophylactic Lymphaticovenular Anastomoses after Axillary or Inguinal Complete Lymph Node Dissection Followed by Radiotherapy: A Case Series. Medicina. 2022; 58(2):207. https://doi.org/10.3390/medicina58020207

Chicago/Turabian Style

Pierazzi, Diletta M., Sergio Arleo, and Gianpaolo Faini. 2022. "Distally Prophylactic Lymphaticovenular Anastomoses after Axillary or Inguinal Complete Lymph Node Dissection Followed by Radiotherapy: A Case Series" Medicina 58, no. 2: 207. https://doi.org/10.3390/medicina58020207

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