Minimal invasive lymphaticovenular anastomosis under local anesthesia for leg lymphedema: Is it effective for stage III and IV?

Isao Koshima, Yuzaburo Namba, Tetsuya Tsutsui, Yoshio Takahashi, Seiko Itoh, Misako Fujitsu

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This is the first report on the effectiveness of minimal invasive lymphaticovenular anastomosis under local anesthesia for leg lymphedema. Fifty-two patients (age: 15 to 78 years old; 8 males, 44 females) were treated with lymphaticovenular anastomoses under local anesthesia and by postoperative compression using elastic stockings. The average duration of edema of these patients before treatment was 5.3 ± 5.0 years. The average number of anastomosis in each patient was 2.1 ± 1.2 (1-5). The patients were followed for an average of 14.5 ± 10.2 months, and the result were considered effective (82.5%) even for the patients with stage III (progressive edema with acute lymphangitis) and IV (fibrolymphedema), but others showed no improvement. Among these cases, 17 patients showed reduction of over 4 cm in the circumference of the lower leg. The average decrease in the circumference excluding edema in bilateral legs was 41.8 ± 31.2% of the preoperative excess length. These results indicate that minimal invasive lymphaticovenular anastomosis under a local anesthesia is valuable instead of general anesthesia.

Original languageEnglish
Pages (from-to)261-266
Number of pages6
JournalAnnals of Plastic Surgery
Issue number3
Publication statusPublished - Sep 2004



  • Lower leg lymphedema
  • Lymphaticovenular anastomosis
  • Lymphedema
  • Microsurgery
  • Supermicrosurgery

ASJC Scopus subject areas

  • Surgery

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