림프부종의 수술적 치료: 림프관-정맥 우회술 및 림프절 전이술

김덕우¹, 이윤환¹^,^*

Lymphovenous Bypass and Lymph Node Transfer

Yoon-Hwan Lee¹, Deok-Woo Kim¹^,^*

¹고려대학교 의과대학 성형외과학교실

¹Department of Plastic and Reconstructive Surgery, Korea University Medical Center, Ansan Hospital, Korea University College of Medicine, Ansan, Korea

^*Corresponding Author : Deok-Woo Kim, MD, PhD, Department of Plastic and Reconstructive Surgery, Korea University Medical Center Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-Gu, Ansan-City, Gyeonggi-do 15355, Korea Tel: +82-31-412-4817, Fax: +82-31-475-5074 E-mail: deokwookim@gmail.com

ⓒ Copyright 2016 Korean Society of Lymphology and Lymphedema. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: Feb 28, 2016; Accepted: Apr 19, 2016

Published Online: Apr 30, 2016

Abatract

Lymphedema is a common and progressive condition complicating cancer treatment. Recent articles report that surgery can effectively treat lymphedema. Lymphovenous bypass and vascularized lymph node transfer are surgical treatment options for lymphedema. The two physiologic surgeries can reduce not only the volume of affected limb but also the risk of infection and cellulitis. Lymphovenous anastomosis is effective for treating early-stage lymphedema before fibrosis occurs but has limited outcomes in advanced lymphedema. Lymph node transfer is an emerging physiologic surgical treatment for lymphedema that shows promise. In patients with mastectomy, vascularized lymph node transfer can also be combined with breast reconstruction flaps to be an elegant treatment. The authors review the literature and announce personal experiences on lymphovenous bypass and lymph node transfer and discuss its possible mechanisms and its role in lymphedema treatment.

Keywords: Lymphedema; Lymphovenous bypass; Lymph node transfer; Near-infrared florescence; Indocyanine green; lymphography