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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  >  > Accepted Manuscript
Wang Junjie,Wang Xuebin,Wang Erping,et al.Clinical effect of multisegmental lymphatic-venous anastomosis in the treatment of post-traumatic lymphedema[J].Chin J Burns Wounds,2026,42(10):1-10.DOI: 10.3760/cma.j.cn501225-20250219-00073.
Citation: Wang Junjie,Wang Xuebin,Wang Erping,et al.Clinical effect of multisegmental lymphatic-venous anastomosis in the treatment of post-traumatic lymphedema[J].Chin J Burns Wounds,2026,42(10):1-10.DOI: 10.3760/cma.j.cn501225-20250219-00073.
shu

Clinical effect of multisegmental lymphatic-venous anastomosis in the treatment of post-traumatic lymphedema

doi: 10.3760/cma.j.cn501225-20250219-00073

  • Department of Microprosthetic Hand Surgery, Ningbo NO.2 Hospital, Ningbo 315010, China

Funds:

Zhejiang Provincial Clinical Key Specialty Construction Project 2024021

Ningbo Clinical Medical Research Center and Major Research Project 2024L004

More Information
  • Corresponding author: Guo Zonghui, Email: gzhcmu@126.com
  • Received Date: 2025-02-19
    Available Online: 2026-09-29
    Abstract
  •   Objective  To investigate the clinical effect of multisegmental lymphatic-venous anastomosis (LVA) in the treatment of post-traumatic lymphedema (PTL).  Methods  This study was a retrospective case series study. From January to August 2024, 7 patients with PTL who met the inclusion criteria were admitted to the Department of Microprosthetic Hand Surgery of Ningbo NO.2 Hospital. There were 3 males and 4 females, aged 51-75 years. The lesions involved the upper limb in 3 patients and the lower limb in 4 patients. All patients underwent multisegmental LVA. Distal to the site of lymphatic injury in the limb, functional collecting lymphatic vessels in the superficial layer of the subdermal fat were anastomosed with adjacent superficial veins with good valvular function. At the site of lymphatic injury in the limb, functional collecting lymphatic vessels in the superficial layer of the deep fascia were anastomosed with adjacent superficial veins with good valvular function. After surgery, all patients received complete decongestive therapy (CDT). The completion of surgery, occurrence of complications, and recurrence of PTL were recorded for the 7 patients. The affected limb circumferences before surgery and at 3 days, 1 month, 3 months, and 6 months after surgery were compared among 3 patients with upper limb involvement and 3 patients with lower limb involvement. Body weight, muscle balance and bioelectrical impedance between the healthy and affected limbs measured by a body composition analyzer before surgery and at 14 days after surgery in 7 patients.  Results  All 7 patients completed the surgery successfully. One patient with upper limb involvement developed lymphangitis in the affected limb at 7 days after surgery. After anti-infective treatment followed by CDT, the limb circumference returned to the level at 3 days after surgery at 1 month after surgery. No adverse surgical complications occurred in the remaining patients. During postoperative follow-up, no recurrence of PTL was observed in the 7 patients. Before surgery and at 3 days, 1 month, 3 months, and 6 months after surgery, the hand and wrist circumferences at the affected side in the 3 patients with upper limb involvement were (20.4±3.6), (20.0±3.0), (19.8±3.2), (19.7±3.0), and (19.5±2.6) cm, respectively; the forearm circumferences were (29±6), (27±5), (26±6), (25±4), and (23±4) cm, respectively; the upper arm circumferences were (35±4), (34±4), (33±5), (32±4), and (31±4) cm, respectively; the foot and ankle circumferences at the affected side in the 3 patients with lower limb involvement were (27±4), (25±4), (25±5), (24±4), and (24±4) cm, respectively; the calf circumferences were (38±9), (35±8), (34±8), (33±8), and (33±8) cm, respectively; the thigh circumferences were (49±10), (47±10), (47±10), (46±10), and (46±10) cm, respectively. At the afftected side of patients, from 3 days to 6 months after surgery, the forearm, upper arm, foot and ankle, calf, and thigh circumferences were all significantly smaller than those before surgery (P<0.05), the forearm circumference at 1 to 6 months after surgery, the upper arm circumference at 3 and 6 months after surgery, the foot and ankle circumference at 3 months after surgery, the calf circumference at 1 to 6 months after surgery, and the thigh circumference at 3 and 6 months after surgery were all significantly smaller than those at 3 days after surgery (P<0.05), the forearm circumference at 3 and 6 months after surgery, the upper arm circumference at 3 and 6 months after surgery, the foot and ankle circumference at 3 months after surgery, and the thigh circumference at 3 and 6 months after surgery were all significantly smaller than those at 1 month after surgery (P<0.05), and the forearm and upper arm circumferences at 6 months after surgery were significantly smaller than those at 3 months after surgery (P<0.05). Compared with those before surgery, the body weight and muscle balance of the affected limb in the 7 patients at 14 days after surgery decreased significantly (with t values of 3.181 and 3.221, respectively, P<0.05), and the bioelectrical impedance of the affected limb increased significantly (t=-6.631, P<0.05).  Conclusions  In the surgical treatment of PTL, multisegmental LVA can reduce the affected limb circumference and effectively improve edema symptoms, and combined with CDT can continuously enhance the therapeutic effect.

     

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