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	症例報告
言語種別	英語
査読の有無	査読あり
表題	Lymphatic-venous anastomosis for the treatment of refractory lymphatic ascites following radiation therapy: A case report.
掲載誌名	正式名：Microsurgery 略　 称：Microsurgery ISSNコード：10982752/07381085
掲載区分	国外
巻・号・頁	42(4),pp.376-380
著者・共著者	Hattori Yoshitsugu, Yamashita Shuji, Furuse Kiichi, Nakatsukasa Shuichi, Iida Takuya
担当区分	2nd著者
発行年月	2022/05
概要	Radical treatments for intra-abdominal malignancies disturb physiological lymphatic drainage and predispose the patients to lymphatic complications such as lymphatic ascites. Despite its infrequent occurrence, lymphatic ascites is a morbid complication, and a definitive treatment protocol for refractory cases has not been established. Surgical treatments are opted depending on the etiology, symptoms, and facility equipment. Lymphatic-venous anastomosis (LVA) bypasses the proximal lymphatic blockages and provides an alternative route for lymphatic fluid recirculation into the venous system, thereby improving the lymphatic congestion. Herein, we report the utility of LVA surgery in the treatment of refractory serous lymphatic ascites that developed after radiation therapy for cervical cancer in a 77-year-old woman. The patient had massive ascites and suffered from abdominal distention and anorexia for 1 year. The ascites was unresponsive to conservative treatment. Under local anesthesia, eight incisions were made in the lower extremities just above the lymphatic channels that were identified by indocyanine green lymphography, and a total of 14 LVAs were created. The postoperative course was uneventful, and the ascites improved significantly. The patient remained free from the recurrence of ascites during 3.5 years of postoperative follow-up. LVA surgery was effective for the improvement and long-term control of lymphatic ascites. This procedure may be a viable option for the management of lymphatic ascites.
DOI	10.1002/micr.30857
PMID	34967462