ヤマシタ　シュウジ   Shuji Yamashita   山下　修二    所属   川崎医科大学  医学部 臨床医学　形成外科学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Combined Lymphovenous Anastomosis and Great Saphenous Vein Stripping for Comorbid Lymphedema and Varicose Veins.
掲載誌名	正式名：Lymphatic research and biology 略　 称：Lymphat Res Biol ISSNコード：15578585/15396851
掲載区分	国外
巻・号・頁	20(2),pp.213-219
著者・共著者	Yoshida Shuhei, Koshima Isao, Imai Hirofumi, Uchiki Toshio, Sasaki Ayano, Fujioka Yumio, Nagamatsu Shogo, Yokota Kazunori, Harima Mitsunobu, Yamashita Shuji
担当区分	最終著者
発行年月	2022/04
概要	Background: Treatment for patients with comorbid lymphedema and varicose veins is controversial. Surgical options for these patients are limited. The study was aimed to investigate the validity of combined lymphovenous anastomosis (LVA) and great saphenous vein stripping (GSVS) for comorbid lymphedema and varicose veins. Methods: Thirteen patients were involved in the study, and the detail was 21 edematous lower limbs (with coexisting varicose veins and lymphedema; the varicose vein and lymphedema [VL] group) who underwent combined GSVS and LVA therapy. Fifteen patients (with 30 edematous lower limbs and lymphedema only; the lymphedema [L] group) who underwent LVA only were included as a control group. GSVS was performed before LVA in the VL group. Results: No significant differences were seen between the groups at baseline. There were no cases indocyanine green (ICG) lymphography pattern deteriorated after GSVS. No significant difference was seen in lymphatic detection rate; 129.71% ± 58.27% (67%-333%) in the VL group and 122.27% ± 39.47% (50%-250%) in the L group (p = 0.59 > 0.05), respective lymphatic diameters 0.66 ± 0.13 (0.45-0.9) mm and 0.75 ± 0.17 (0.45-1.0) mm (p = 0.07 > 0.05), and respective lymphedema improvement rate 12.17% ± 7.35% (0%-27.4%) and 12.65% ± 7.43% (3.7%-22.3%) (p = 0.86 > 0.05). Discussion: In this study, stripping surgery does not cause lymphatic impairment, at least to the extent that would impede the success of an LVA procedure. Comorbid varicose veins and lymphedema can be treated surgically by a combination of LVA and GSVS.
DOI	10.1089/lrb.2019.0076
PMID	33794104