J 2024

Comparison of contraction-type and noncontraction-type lymphatic vessels in lymphaticovenous anastomosis for cancer-related unilateral lower limb lymphedema: a retrospective cohort propensity-score-matched outcome analysis

KNOZ, Martin, Yu-Ming WANG, Sheng-Dean LUO, Shao-Chun WU, Wei-Che LIN et. al.

Basic information

Original name

Comparison of contraction-type and noncontraction-type lymphatic vessels in lymphaticovenous anastomosis for cancer-related unilateral lower limb lymphedema: a retrospective cohort propensity-score-matched outcome analysis

Authors

KNOZ, Martin (203 Czech Republic, belonging to the institution), Yu-Ming WANG, Sheng-Dean LUO, Shao-Chun WU, Wei-Che LIN, Pei-Yu TSAI, Peng-Chen CHIEN, Ching-Hua HSIEH and Johnson Chia-Shen YANG

Edition

INTERNATIONAL JOURNAL OF SURGERY, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2024, 1743-9191

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 15.300 in 2022

Organization unit

Faculty of Medicine

UT WoS

001203304700013

Keywords in English

contraction-type; lymphatic vessels; lymphaticovenous anastomosis; lymphedema; NECST classification; noncontraction type; supermicrosurgery

Tags

Tags

International impact, Reviewed
Změněno: 20/8/2024 13:25, Mgr. Tereza Miškechová

Abstract

V originále

Background:Contraction-type lymphatic vessels (LV) are considered suboptimal for lymphaticovenous anastomosis (LVA). However, despite these pathological changes, their functionality and link to outcomes have not been fully elucidated. The aim of this study was to determine the impact on outcomes when contraction-type LVs were used for LVA compared to the noncontraction-type (normal + ectatic) counterpart for treating lower limb lymphedema. Study design:Eighty-three patients with gynecologic cancer-related unilateral lower-limb lymphedema who underwent LVA as their primary treatment were enrolled in this study. The study group included 20 patients who used only contraction-type LVs. An additional 63 patients (control group) received noncontraction-type LVs only. Patients with a history of LVA, liposuction, or excisional therapy were excluded. Patient characteristics, intraoperative findings, functional parameters, and pre-LVA and post-LVA volume changes were recorded and matched using propensity scores. The primary endpoint was the volume change at 6/12 months after LVA. Results:After matching, 20 patients were included in each group. All parameters were matched, except that the study group still had a significantly inferior indocyanine green (ICG)-positive ratio, lymph flow-positive ratio, and washout-positive ratios (P<0.001, P=0.003, and P<0.001, respectively) when compared to the control group after matching. However, at 1-year follow-up, the postoperative percentage volume reduction was comparable between the groups (P=0.619). Conclusion:The use of contraction-type LVs for LVA is encouraged when no other LVs are available.