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Lymphoscintigraphic Findings as Indicators of Lymphaticovenous Anastomosis Outcome in Patients with Extremity Lymphedema: A Retrospective Cohort Study
- Title
- Lymphoscintigraphic Findings as Indicators of Lymphaticovenous Anastomosis Outcome in Patients with Extremity Lymphedema: A Retrospective Cohort Study
- Authors
- Kim H.O.; Woo K.-J.; Kim B.S.; Kang S.Y.; Moon B.S.; Yoon H.-J.
- Ewha Authors
- 김범산; 윤혜전; 우경제; 문병석; 김혜옥
- SCOPUS Author ID
- 김범산; 윤혜전; 우경제; 문병석; 김혜옥
- Issue Date
- 2021
- Journal Title
- Clinical Nuclear Medicine
- ISSN
- 0363-9762
- Citation
- Clinical Nuclear Medicine vol. 46, no. 7, pp. 549 - 555
- Keywords
- lymphaticovenous anastomosis; lymphedema; lymphoscintigraphy; prognosis
- Publisher
- Lippincott Williams and Wilkins
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Purpose This study was performed to evaluate the usefulness of lymphoscintigraphy in predicting the surgical outcomes of lymphaticovenous anastomosis (LVA) in a patient with extremity lymphedema. Patients and Methods We retrospectively evaluated 133 patients with extremity lymphedema who underwent lymphoscintigraphy followed by LVA surgery from February 2018 to March 2020. Lymphoscintigraphic findings were evaluated on the following parameters: the extent of dermal backflow (small/large), lymphatic flow patterns (trunk flow pattern/proximal-restricted pattern/distal-restricted pattern), visualization of lymph nodes, and collateral lymphatic vessels. The mean circumferential difference change before and after surgery, circumferential reduction (CR) rate (%), was used as the clinical outcome variables. Results A decrease in circumference was observed in 93 (69.9%) of 133 patients after LVA. The extent of dermal backflow and lymphatic flow patterns was significantly correlated with improved clinical outcomes after LVA. The large extent of the dermal backflow group showed a more significant CR rate than the small extent (19.27% vs 1.24%, P = 0.005). The TP group showed the most significantly decreased CR rate to 21.46%, and the proximal-restricted pattern and distal-restricted pattern groups were -2.49% and -5.33%, respectively (P < 0.001). Multivariate analysis revealed that dermal backflow and lymphatic flow patterns were independent predictors of therapeutic outcome (P < 0.001). Conclusions Our study demonstrates that pretreatment lymphoscintigraphy may help predict the therapeutic effect of LVA in patients with extremity lymphedema. Furthermore, dermal backflow and lymphatic flow patterns are independent predictors of CR rate after LVA surgery for extremity lymphedema. © Wolters Kluwer Health, Inc. All rights reserved.
- DOI
- 10.1097/RLU.0000000000003630
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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