Lymphatic–venous anastomosis

Abstract

Lymphatic–venous anastomosis is performed for the treatment of chronic lymphedema; however, its indications, true results, and other features are still unclear. In this chapter, the author demonstrates the surgical indications of lymphatic–venous anastomosis using lymphoscintigraphy images, techniques of lymphaticovenous side-to-end anastomosis (LVSEA), postoperative patency of the anastomosis by ICG fluorescence lymphography, and net effects of lymphatic–venous anastomosis on volume reduction. Lymphatic–venous anastomosis, if indicated, is a useful therapeutic option for lymphedema, particularly in combination with compression therapy before and after surgery. In addition, compression therapy can be reduced or terminated postoperatively in some patients who undergo lymphatic–venous anastomosis.