Shuji Yamashita
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of Plastic and Reconstructive Surgery,
   Position   Professor
Article types 原著
Language English
Peer review Peer reviewed
Title Combined Lymphovenous Anastomosis and Great Saphenous Vein Stripping for Comorbid Lymphedema and Varicose Veins.
Journal Formal name：Lymphatic research and biology
Abbreviation：Lymphat Res Biol
ISSN code：15578585/15396851
Domestic / ForeginForegin
Volume, Issue, Page 20(2),pp.213-219
Author and coauthor Yoshida Shuhei, Koshima Isao, Imai Hirofumi, Uchiki Toshio, Sasaki Ayano, Fujioka Yumio, Nagamatsu Shogo, Yokota Kazunori, Harima Mitsunobu, Yamashita Shuji
Authorship Last author
Publication date 2022/04
Summary 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