Recently, the Department of Hand and Foot Microsurgery of the First People's Hospital of Chenzhou City has successfully carried out ultra-microscopic lymphatic venous anastomosis (LVA), the main purpose of which is secondary lymphedema.
Yizhang's 77-year-old grandmother Wu, after acupuncture for lumbar disc herniation, there is no obvious cause of swelling of the right lower limb, difficulty walking, weakness in lifting the leg, the swelling has increased significantly in the past month, the middle circumference of the right foot is greater than the circumference of the left foot is greater than 10cm, the circumference of the right ankle is greater than the circumference of the left ankle by 5cm, the right leg is swollen like an "elephant's leg", and the constantly edematous thigh brings great trouble to Grandma Wu.
The family took her around for medical treatment, and learned that the Department of Hand and Foot Microsurgery of the First People's Hospital of Chenzhou City was carrying out the project of "lymphatic venous anastomosis" ** lymphedema, and immediately found the chief physician of the department director He Yusheng, hoping to ** her "elephant legs" as soon as possible, and also let the elderly celebrate the New Year happily.
After full preparation, on the morning of January 23, the team led by Chief Physician He Yusheng and Deputy Chief Physician Liu Xiaoren of Hand and Foot Microsurgery successfully carried out "ultra-microscopic" peripheral lymphangic-venous anastomosis (LVA) surgery for a column of patients with lymphedema of the lower limbs, and the operation lasted more than 10 hours from preparation to completion, and the operation process was very smooth.
Chief Physician He Yusheng and Deputy Chief Physician Liu Xiaoren performed LVA surgery for the patient).
The implementation of this operation fills the technical gap in the field of limb lymphedema microscopic technology in Chenzhou City, and marks a new level of lymphedema microscopic diagnosis and treatment technology in the First People's Hospital of Chenzhou City!
One week after the operation, Director He Yusheng measured Grandma Wu's circumference of her right foot by 6cm and her right ankle circumference by 3cm compared with before the operation, which fully met the discharge index.
Patients were admitted to the hospital before and after the post-operative control).
The patient's ETC results showed complete right-sided lymph obstruction).
Lymphedema is still a worldwide problem, and it is mainly comprehensive. In the past decade, with the development of microscopic technology, "ultra-microscopic" lymphovenous anastomosis surgery has received more and more attention and application in China and abroad.
Lymphovenous anastomosis is the use of "ultra-microsurgical techniques" to anastomosis the superficial lymphatic vessels and the surrounding venules to re-establish the lymphatic-venous flow pathway. It is currently the "gold standard" of lymphedema surgery.
Chief physician He Yusheng performed ICG imaging for the patient before surgery to locate the lymphatic direction).
Indocyanine green (ICG) imaging was used to show the movement of lymphatic vessels before surgery, and the location of the lymphatic vessels and veins was determined and marked. In surgery, an incorporating of about 3 cm is made at a location where the selected lymphatic vessels and veins are close to each other, and the superficial veins are found under the dermis and the lymphatic vessels are found under the superficial fascia under a high-powered surgical microscope for anastomosis. Generally, the diameter of lymphatic vessels and venules is 02-0.The diameter of the tube is almost as close to the limit of human surgical precision, so it is called "ultra-microscopic" surgery.
After the successful anastomosis of the lymphatic vessels and venules, the lymphatic vessels that accumulate a large amount of lymphatic fluid communicate with the low-pressure venous system, and the favorable pressure gradient will promote the flow of lymphatic fluid to the veins, and the lymphatic pressure will decrease significantly, and lymphedema can be relieved. This procedure can effectively improve lymphatic drainage without disrupting physiological lymphatic flow. Since the surgical area only involves superficial tissues outside the muscles, and the surgical incision is relatively small, it is safe and the damage to the patient is very small.
In order to break through this new technology project, a lot of preparatory work has been done in the early stage, and preliminary research has also been carried out on patients with lymphedema in Chenzhou City, for example, upper limb edema after breast cancer** is a more common secondary edema, especially for patients who have undergone axillary lymph node dissection surgery and axillary radiotherapy**, and its incidence can be as high as 30%. In addition to limb swelling, it is prone to recurrent chronic inflammation, ulceration and other conditions.
At present, the main treatment of lymphedema is comprehensive swelling reduction and surgery. With the difficult operation of venous ultramicrosurgical anastomosis, lymphedema** and relief can be completed, so that patients can recover and be discharged in just about a week, which can greatly reduce and alleviate the pain of patients, and significantly improve the quality of life of patients after surgery.
At present, the microsurgery team of the First People's Hospital of Chenzhou City will be committed to the scientific evaluation of every lymphoedema patient in the reception, and formulate an individualized diagnosis and treatment plan, including first-class training guidance and lymphedema surgery, so as to help more lymphedema patients solve problems, restore confidence and return to normal life.
Hunan Medical Chat Special Author: Chenzhou First People's Hospital Tang Jingxia Follow @Hunan Medical Chat to get more health science information!
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