BACKGROUND Lower extremity lymphedema is a common complication following treatment for gynecological malignancies.Its incidence rate can reach up to 70%,affecting~20 million people worldwide.However,specialized treatm...BACKGROUND Lower extremity lymphedema is a common complication following treatment for gynecological malignancies.Its incidence rate can reach up to 70%,affecting~20 million people worldwide.However,specialized treatment centers are scarce,and there is a lack of consensus on treatment approaches.Furthermore,there are even fewer reports on the systematic and effective treatment of severe lymphedema with malformations.Effective management of this condition remains a significant challenge for clinicians.CASE SUMMARY A 40-year-old woman developed bilateral leg swelling 6 years after receiving treatment for endometrial cancer.Since August 2018,she experienced>30 episodes of lymphangitis.Upon presentation,she exhibited bilateral leg swelling and deformation,with four large swellings in the posterior thigh that impeded movement,and pain in the limbs.Skin manifestations included lichenoid lesions and features of deep sclerosis.Radionuclide lymphoscintigraphy confirmed the diagnosis of lower limb lymphedema.After 6 mo of complex decongestive therapy(CDT)and three lymphaticovenous anastomosis(LVA)treatments,the patient lost 49 kg in weight.She also experienced a maximum circumference reduction of 35.2 cm in the left lower limb and 37.5 cm in the right lower limb.The leg pain disappeared,her swelling significantly decreased,and she regained the ability to walk,cycle,and run normally.CONCLUSION The combined application of CDT and LVA therapy demonstrates significant positive effects in the treatment of severe,deformed stage III lymphedema.展开更多
Background:To assess the edema relief effects of complex decongestive therapy(CDT)in patients with breast cancer associated lymphedema after axillary lymph node dissection(ALND).Methods:58 breast cancer patients with ...Background:To assess the edema relief effects of complex decongestive therapy(CDT)in patients with breast cancer associated lymphedema after axillary lymph node dissection(ALND).Methods:58 breast cancer patients with unilateral arm lymphedema after breast cancer ALND were enrolled.The patients were divided into three groups based on the difference of circumference between the affected and unaffected extremity:group 1,mild lymphedema in circumference difference;group 2,moderate lymphedema,and group 3,severe lymphedema.These patients received four weeks of CDT and self-administered home therapy.Arm circumference was measured before,right after CDT,3 months and 12 months of follow-up.Results:In the first group,the circumference difference was 1.53±0.73 cm prior to CDT,and 0.32±0.59 cm right after CDT,and the difference was statistically significant(P<0.001).At the 1-year-follow-up,we got an even higher value than the pre-CDT one,however,there was no significant difference(P=0.175).At the end of CDT,the circumference difference of the third group was 4.52±2.58 cm,significantly lower than the baseline level(8.76±3.07 cm)(P<0.001).In the third group,the reduction of circumference difference was persisted for 12 months.Conclusion:The effects of CDT were maintained for 12 months,while there were differences in progress of circumference difference among the three groups.The effects of patients with severe initial edema(>5 cm increased)last longer.展开更多
Objective: Past studies showed that tumor necrosis factor (TNF) assisted anti-tumor treatment and intensified the sensitivity of chemotherapy. However its clinical application has been curbed because of its low purity...Objective: Past studies showed that tumor necrosis factor (TNF) assisted anti-tumor treatment and intensified the sensitivity of chemotherapy. However its clinical application has been curbed because of its low purity, high dosage, and strong toxicity. The objective of present study is to evaluate the therapeutic effects and adverse reactions of recombinant mutant human tumor necrosis factor (rmhTNF) combined with chemotherapy in patients with advanced malignant tumor. Methods: 105 patients with advanced malignant tumor were randomly divided into trial group, 69 patients, and control group, 36 patients. rmhTNF was injected intramuscularly to the trial group at a dose of 4×106 U/m2, from the 1st to 7th days, the 11th to 17th days combined with chemotherapy course. The chemotherapy plan was as follows: CAP for patients with the NSCLC; FAM for patients with gastric cancer; FC for patients with colorectal cancer. One treatment cycle lasted for 21 days and two cycles were scheduled. The control group was given only the same chemotherapy as the trial group. Results: In the trial group there was 1 CR case and 12 PR cases, and the response rate was 13/69 (18.84%); in the control group 1 PR case, the response rate 1/36 (2.78%). The response rate in the trial group was significantly higher than that in the control group (P=0.022). The response rate for NSCLC in the trial group was 8/17 (47.06%), and 1/6 (16.67%) in the control group. The response rates for gastric cancer and colorectal cancer in the trial groups also were higher than those in the control groups. After the treatment the KPS was 89.00±9.92 in the trial group, and 84.17±8.84 in the control group, with a significant difference between the two groups (P=0.028). The adverse reactions of rmhTNF injection included: pain in the injection area, chill, hardening and swelling and redness in the injection area, fever, ostealgia and myosalgia, and cold-like symptoms. All these adverse reactions were mild and bearable. Conclusion: The administration of rmhTNF in combination with general chemotherapy is an effective and secure means in treating advanced malignant tumor.展开更多
To explore the effects of bandage technology and pressure therapy in breast cancer with lymphedema.Methods A total of 91 patients,with breast cancer-related lymphedema and hospitalized in a third-class hospital in Jia...To explore the effects of bandage technology and pressure therapy in breast cancer with lymphedema.Methods A total of 91 patients,with breast cancer-related lymphedema and hospitalized in a third-class hospital in Jiangsu Province from May to December,2018,were selected and sequenced in class“ABC”in the order of entry.The patients in class“A”were enrolled in“8”shaped bandaging group.The patients in class“B”were enrolled in“5”spiral bandaging group.The patients in class“C”were enrolled in combined bandage group.The primary outcome was the degree of limb swelling used by multiple-frequency bioelectrical impedance analysis.Secondary outcomes were the amount of bandage losses,counting 24-hour bandage loose occurrences and patients satisfaction.All outcomes were evaluated both before and after treatment.Results After treatment,there was a significant difference in the regression of limb swelling in all three groups(P<0.05).However,the largest amplitude of regression was observed in combined bandage group(limb circumference ratio:53%and tissue water ratio:68%).Although“8”bandaging group had large material,bandage cost and minimum comfort,the bandage has good stability and no case of 24-hour bandage loose occurrences was found in this group.The“5”partial binding group had an advantage in the amount of bandage losses and comfort level,but among which 3 patients had the phenomenon of loose bandage at the joint.The combined bandage group had the best therapeutic effect in limb swelling and patients satisfaction(P<0.05).Conclusion The combined bandage group significantly decreased the degree of limb swelling and 24-hour bandage loose occurrences.Importantly,this treatment improved the degree of patients’satisfaction.The treatment of“8”shaped bandaging combined with spiral bandaging is worthy of clinical promotion.展开更多
Lymphedema,particularly in its advanced stages,presents significant challenges in treatment,often necessitating a combination of therapies to manage symptoms effectively and improve patient outcomes.This article revie...Lymphedema,particularly in its advanced stages,presents significant challenges in treatment,often necessitating a combination of therapies to manage symptoms effectively and improve patient outcomes.This article reviews the findings of Wang et al,regarding the use of lymphovenous anastomosis and complex decongestive therapy in treating severe,deformed stage III lymphedema with recurrent infections.The case report details the promising results achieved through this combined therapy,highlighting substantial reductions in limb volume and the complete resolution of recurrent lymphangitis.The patient experienced notable improvements in weight loss,physical function,and quality of life.Despite its strengths,the study has several limitations.It lacks specific details on the types of lymphovenous anastomoses performed and complex decongestive therapy protocols,such as frequency and adherence,making reproducibility difficult.The short follow-up period of six months limits understanding of long-term efficacy,and more consistent reporting of key metrics such as weight loss and body mass index would enhance outcome assessments.This article emphasizes the importance of integrating minimally invasive surgical techniques with conservative therapies to address both the symptoms and underlying causes of lymphedema.Further research is essential to standardize protocols and refine combined treatment strategies.展开更多
Lymphedema is a prevalent complication affecting patients with breast cancer,greatly impacting their quality of life.This editorial describes diagnostic methods and therapeutic interventions for managing lymphedema in...Lymphedema is a prevalent complication affecting patients with breast cancer,greatly impacting their quality of life.This editorial describes diagnostic methods and therapeutic interventions for managing lymphedema in patients with breast cancer.Diagnosis relies on clinical evaluation and objective measures,including arm circumference and volumetric assessments,along with lymphoscintigraphy and ultrasonic measurements.Treatment primarily involves complex decongestive physical therapy,comprising manual lymphatic drainage,compression therapy,exercise,and meticulous skin care.These interventions aim to reduce swelling,alleviate discomfort,and prevent further complications.Additionally,lifestyle modifications such as avoiding extreme temperatures and maintaining proper hygiene are essential.Flavonoids can be used for drug therapy.Despite its prevalence,lymphedema often receives inadequate attention in clinical practice,emphasizing the importance of raising awareness and enhancing medical services for affected individuals.Clinicians play a pivotal role in educating patients about preventive measures and ensuring timely intervention.Overall,a comprehensive approach encompassing early diagnosis,multidisciplinary management,and patient education is essential to mitigate the burden of lymphedema in patients with breast cancer and improve their overall well-being.展开更多
Aim:This study aimed to clarify the efficacy of the integration of lymphaticovenular anastomosis(LVA)and perioperative reduction treatment in the exploration of optimal combination of surgery and conservative therapy ...Aim:This study aimed to clarify the efficacy of the integration of lymphaticovenular anastomosis(LVA)and perioperative reduction treatment in the exploration of optimal combination of surgery and conservative therapy for lymphedema.Methods:We conducted a retrospective chart review of 134 consecutive patients with lower extremity lymphedema who were treated with LVA.A total of 116 patients were included,and they were divided into two groups:patients who underwent perioperative reduction treatment(PORT)following LVA surgery(PORT group,51 patients)and patients who underwent no additional perioperative intervention after LVA surgery(control group,65 patients).PORT included compression therapy and remedial exercise.A total of 41 matched pairs were extracted after propensity score matching analysis.The edema reduction effect was compared between the two groups.Results:Patients who underwent PORT had a significantly higher edema reduction than those in the control group(reduction in lower extremity lymphedema index,14.7 vs.6.7;P=0.03).No unfavorable complications related to PORT were observed in our cohort.Conclusion:It would be highly beneficial to combine reduction treatment in the early postoperative period after LVA surgery to maximize treatment outcomes.展开更多
Aim:Lymphedema is a progressive degenerative disease that can cause severe swelling and recurrent infections.Conservative and surgical treatments,such as lymphaticovenous anastomosis(LVA),are available;however,the opt...Aim:Lymphedema is a progressive degenerative disease that can cause severe swelling and recurrent infections.Conservative and surgical treatments,such as lymphaticovenous anastomosis(LVA),are available;however,the optimal timing for LVA after the initiation of complex decongestive therapy(CDT)remains unclear.This study aimed to evaluate the effect of CDT duration prior to LVA on the treatment outcomes of upper extremity lymphedema.Methods:Fifty patients with stage II upper extremity lymphedema who underwent LVA were retrospectively evaluated.Patients were divided into two groups based on the duration of CDT before LVA:<6 months(early group)and>6 months(non-early group).The primary outcome measures were percent excess volume(PEV)and reduction rate 12 months after LVA.Results:The early group(CDT<6 months)showed significantly better outcomes than the non-early group(CDT>6 months).The early group had a lower PEV(4%)and a higher reduction rate(56%)than the non-early group(PEV of 10%and reduction rate of 25%)at 12 months after LVA.Conclusions:Early indication for LVA(within 6 months of CDT initiation)resulted in better treatment outcomes for stage II upper extremity lymphedema.This study highlights the potential benefits of early surgical intervention for improving the prognosis of lymphedema.展开更多
Aim:To evaluate the effectiveness of lymphovenular anastomosis(LVA)under local anesthesia for patients with high American Society of Anesthesiologists Physical Status(ASA PS)score.Methods:From January 2019 to January ...Aim:To evaluate the effectiveness of lymphovenular anastomosis(LVA)under local anesthesia for patients with high American Society of Anesthesiologists Physical Status(ASA PS)score.Methods:From January 2019 to January 2021,we collected a total of 29 patients with lymphedema stage III and IV,operated upon with LVA by a single surgeon in a medical center.These patients had poor responses to compression therapies.After surgery,the patients underwent complex decongestive therapy consisting of the continuous wearing of an elastic stocking.To examine the effect of LVA,all data were collected,and differences in preoperative and postoperative means were analyzed.Results:Twenty-nine patients with high ASA PS score(>3)were followed after lymphovenular anastomosis and postoperative compression therapies.Twenty-one of 29 patients were survivors of oncological diseases and continued oncological therapies.The average duration of edema of these patients before LVA was 25±5.0 years.The average number of anastomosis for each patient was 6.8±2.2;the methods of anesthesia had no significant influence on these numbers.The average follow-up period was 7.8±0.85 months,and the result was considered effective(26/29 patients;89.7%).The average reduction of the circumference in affected limbs was 4.40%±3.67%of the preoperative excess length.There were no perioperative complications in this study.Conclusion:Lymphovenular anastomosis can be performed under local anesthesia,especially in patients with high risks of general anesthesia(ASA PS score>3).By this way,we could achieve adequate anastomosis and effective treatment of lymphedema in advanced cancer patients as well.展开更多
文摘BACKGROUND Lower extremity lymphedema is a common complication following treatment for gynecological malignancies.Its incidence rate can reach up to 70%,affecting~20 million people worldwide.However,specialized treatment centers are scarce,and there is a lack of consensus on treatment approaches.Furthermore,there are even fewer reports on the systematic and effective treatment of severe lymphedema with malformations.Effective management of this condition remains a significant challenge for clinicians.CASE SUMMARY A 40-year-old woman developed bilateral leg swelling 6 years after receiving treatment for endometrial cancer.Since August 2018,she experienced>30 episodes of lymphangitis.Upon presentation,she exhibited bilateral leg swelling and deformation,with four large swellings in the posterior thigh that impeded movement,and pain in the limbs.Skin manifestations included lichenoid lesions and features of deep sclerosis.Radionuclide lymphoscintigraphy confirmed the diagnosis of lower limb lymphedema.After 6 mo of complex decongestive therapy(CDT)and three lymphaticovenous anastomosis(LVA)treatments,the patient lost 49 kg in weight.She also experienced a maximum circumference reduction of 35.2 cm in the left lower limb and 37.5 cm in the right lower limb.The leg pain disappeared,her swelling significantly decreased,and she regained the ability to walk,cycle,and run normally.CONCLUSION The combined application of CDT and LVA therapy demonstrates significant positive effects in the treatment of severe,deformed stage III lymphedema.
文摘Background:To assess the edema relief effects of complex decongestive therapy(CDT)in patients with breast cancer associated lymphedema after axillary lymph node dissection(ALND).Methods:58 breast cancer patients with unilateral arm lymphedema after breast cancer ALND were enrolled.The patients were divided into three groups based on the difference of circumference between the affected and unaffected extremity:group 1,mild lymphedema in circumference difference;group 2,moderate lymphedema,and group 3,severe lymphedema.These patients received four weeks of CDT and self-administered home therapy.Arm circumference was measured before,right after CDT,3 months and 12 months of follow-up.Results:In the first group,the circumference difference was 1.53±0.73 cm prior to CDT,and 0.32±0.59 cm right after CDT,and the difference was statistically significant(P<0.001).At the 1-year-follow-up,we got an even higher value than the pre-CDT one,however,there was no significant difference(P=0.175).At the end of CDT,the circumference difference of the third group was 4.52±2.58 cm,significantly lower than the baseline level(8.76±3.07 cm)(P<0.001).In the third group,the reduction of circumference difference was persisted for 12 months.Conclusion:The effects of CDT were maintained for 12 months,while there were differences in progress of circumference difference among the three groups.The effects of patients with severe initial edema(>5 cm increased)last longer.
文摘Objective: Past studies showed that tumor necrosis factor (TNF) assisted anti-tumor treatment and intensified the sensitivity of chemotherapy. However its clinical application has been curbed because of its low purity, high dosage, and strong toxicity. The objective of present study is to evaluate the therapeutic effects and adverse reactions of recombinant mutant human tumor necrosis factor (rmhTNF) combined with chemotherapy in patients with advanced malignant tumor. Methods: 105 patients with advanced malignant tumor were randomly divided into trial group, 69 patients, and control group, 36 patients. rmhTNF was injected intramuscularly to the trial group at a dose of 4×106 U/m2, from the 1st to 7th days, the 11th to 17th days combined with chemotherapy course. The chemotherapy plan was as follows: CAP for patients with the NSCLC; FAM for patients with gastric cancer; FC for patients with colorectal cancer. One treatment cycle lasted for 21 days and two cycles were scheduled. The control group was given only the same chemotherapy as the trial group. Results: In the trial group there was 1 CR case and 12 PR cases, and the response rate was 13/69 (18.84%); in the control group 1 PR case, the response rate 1/36 (2.78%). The response rate in the trial group was significantly higher than that in the control group (P=0.022). The response rate for NSCLC in the trial group was 8/17 (47.06%), and 1/6 (16.67%) in the control group. The response rates for gastric cancer and colorectal cancer in the trial groups also were higher than those in the control groups. After the treatment the KPS was 89.00±9.92 in the trial group, and 84.17±8.84 in the control group, with a significant difference between the two groups (P=0.028). The adverse reactions of rmhTNF injection included: pain in the injection area, chill, hardening and swelling and redness in the injection area, fever, ostealgia and myosalgia, and cold-like symptoms. All these adverse reactions were mild and bearable. Conclusion: The administration of rmhTNF in combination with general chemotherapy is an effective and secure means in treating advanced malignant tumor.
基金Project of National Clinical Research Base of Traditional Chinese Medicine in Jiangsu Province,China(Jiangsu Province Academy of Traditional Chinese Medicine),Grant Number:JD2019SZXZD05The Third Open Subject of the Superiority of Nursing in Nanjing University of Traditional Chinese Medicine,Grant Number:2019YSHL127.
文摘To explore the effects of bandage technology and pressure therapy in breast cancer with lymphedema.Methods A total of 91 patients,with breast cancer-related lymphedema and hospitalized in a third-class hospital in Jiangsu Province from May to December,2018,were selected and sequenced in class“ABC”in the order of entry.The patients in class“A”were enrolled in“8”shaped bandaging group.The patients in class“B”were enrolled in“5”spiral bandaging group.The patients in class“C”were enrolled in combined bandage group.The primary outcome was the degree of limb swelling used by multiple-frequency bioelectrical impedance analysis.Secondary outcomes were the amount of bandage losses,counting 24-hour bandage loose occurrences and patients satisfaction.All outcomes were evaluated both before and after treatment.Results After treatment,there was a significant difference in the regression of limb swelling in all three groups(P<0.05).However,the largest amplitude of regression was observed in combined bandage group(limb circumference ratio:53%and tissue water ratio:68%).Although“8”bandaging group had large material,bandage cost and minimum comfort,the bandage has good stability and no case of 24-hour bandage loose occurrences was found in this group.The“5”partial binding group had an advantage in the amount of bandage losses and comfort level,but among which 3 patients had the phenomenon of loose bandage at the joint.The combined bandage group had the best therapeutic effect in limb swelling and patients satisfaction(P<0.05).Conclusion The combined bandage group significantly decreased the degree of limb swelling and 24-hour bandage loose occurrences.Importantly,this treatment improved the degree of patients’satisfaction.The treatment of“8”shaped bandaging combined with spiral bandaging is worthy of clinical promotion.
文摘Lymphedema,particularly in its advanced stages,presents significant challenges in treatment,often necessitating a combination of therapies to manage symptoms effectively and improve patient outcomes.This article reviews the findings of Wang et al,regarding the use of lymphovenous anastomosis and complex decongestive therapy in treating severe,deformed stage III lymphedema with recurrent infections.The case report details the promising results achieved through this combined therapy,highlighting substantial reductions in limb volume and the complete resolution of recurrent lymphangitis.The patient experienced notable improvements in weight loss,physical function,and quality of life.Despite its strengths,the study has several limitations.It lacks specific details on the types of lymphovenous anastomoses performed and complex decongestive therapy protocols,such as frequency and adherence,making reproducibility difficult.The short follow-up period of six months limits understanding of long-term efficacy,and more consistent reporting of key metrics such as weight loss and body mass index would enhance outcome assessments.This article emphasizes the importance of integrating minimally invasive surgical techniques with conservative therapies to address both the symptoms and underlying causes of lymphedema.Further research is essential to standardize protocols and refine combined treatment strategies.
基金Supported by The National Research Foundation of Korea Grant funded by the Korea Government,No.00219725.
文摘Lymphedema is a prevalent complication affecting patients with breast cancer,greatly impacting their quality of life.This editorial describes diagnostic methods and therapeutic interventions for managing lymphedema in patients with breast cancer.Diagnosis relies on clinical evaluation and objective measures,including arm circumference and volumetric assessments,along with lymphoscintigraphy and ultrasonic measurements.Treatment primarily involves complex decongestive physical therapy,comprising manual lymphatic drainage,compression therapy,exercise,and meticulous skin care.These interventions aim to reduce swelling,alleviate discomfort,and prevent further complications.Additionally,lifestyle modifications such as avoiding extreme temperatures and maintaining proper hygiene are essential.Flavonoids can be used for drug therapy.Despite its prevalence,lymphedema often receives inadequate attention in clinical practice,emphasizing the importance of raising awareness and enhancing medical services for affected individuals.Clinicians play a pivotal role in educating patients about preventive measures and ensuring timely intervention.Overall,a comprehensive approach encompassing early diagnosis,multidisciplinary management,and patient education is essential to mitigate the burden of lymphedema in patients with breast cancer and improve their overall well-being.
文摘Aim:This study aimed to clarify the efficacy of the integration of lymphaticovenular anastomosis(LVA)and perioperative reduction treatment in the exploration of optimal combination of surgery and conservative therapy for lymphedema.Methods:We conducted a retrospective chart review of 134 consecutive patients with lower extremity lymphedema who were treated with LVA.A total of 116 patients were included,and they were divided into two groups:patients who underwent perioperative reduction treatment(PORT)following LVA surgery(PORT group,51 patients)and patients who underwent no additional perioperative intervention after LVA surgery(control group,65 patients).PORT included compression therapy and remedial exercise.A total of 41 matched pairs were extracted after propensity score matching analysis.The edema reduction effect was compared between the two groups.Results:Patients who underwent PORT had a significantly higher edema reduction than those in the control group(reduction in lower extremity lymphedema index,14.7 vs.6.7;P=0.03).No unfavorable complications related to PORT were observed in our cohort.Conclusion:It would be highly beneficial to combine reduction treatment in the early postoperative period after LVA surgery to maximize treatment outcomes.
文摘Aim:Lymphedema is a progressive degenerative disease that can cause severe swelling and recurrent infections.Conservative and surgical treatments,such as lymphaticovenous anastomosis(LVA),are available;however,the optimal timing for LVA after the initiation of complex decongestive therapy(CDT)remains unclear.This study aimed to evaluate the effect of CDT duration prior to LVA on the treatment outcomes of upper extremity lymphedema.Methods:Fifty patients with stage II upper extremity lymphedema who underwent LVA were retrospectively evaluated.Patients were divided into two groups based on the duration of CDT before LVA:<6 months(early group)and>6 months(non-early group).The primary outcome measures were percent excess volume(PEV)and reduction rate 12 months after LVA.Results:The early group(CDT<6 months)showed significantly better outcomes than the non-early group(CDT>6 months).The early group had a lower PEV(4%)and a higher reduction rate(56%)than the non-early group(PEV of 10%and reduction rate of 25%)at 12 months after LVA.Conclusions:Early indication for LVA(within 6 months of CDT initiation)resulted in better treatment outcomes for stage II upper extremity lymphedema.This study highlights the potential benefits of early surgical intervention for improving the prognosis of lymphedema.
文摘Aim:To evaluate the effectiveness of lymphovenular anastomosis(LVA)under local anesthesia for patients with high American Society of Anesthesiologists Physical Status(ASA PS)score.Methods:From January 2019 to January 2021,we collected a total of 29 patients with lymphedema stage III and IV,operated upon with LVA by a single surgeon in a medical center.These patients had poor responses to compression therapies.After surgery,the patients underwent complex decongestive therapy consisting of the continuous wearing of an elastic stocking.To examine the effect of LVA,all data were collected,and differences in preoperative and postoperative means were analyzed.Results:Twenty-nine patients with high ASA PS score(>3)were followed after lymphovenular anastomosis and postoperative compression therapies.Twenty-one of 29 patients were survivors of oncological diseases and continued oncological therapies.The average duration of edema of these patients before LVA was 25±5.0 years.The average number of anastomosis for each patient was 6.8±2.2;the methods of anesthesia had no significant influence on these numbers.The average follow-up period was 7.8±0.85 months,and the result was considered effective(26/29 patients;89.7%).The average reduction of the circumference in affected limbs was 4.40%±3.67%of the preoperative excess length.There were no perioperative complications in this study.Conclusion:Lymphovenular anastomosis can be performed under local anesthesia,especially in patients with high risks of general anesthesia(ASA PS score>3).By this way,we could achieve adequate anastomosis and effective treatment of lymphedema in advanced cancer patients as well.
