Lympahtico venous anastomosis and resection for genital acquired lymphangiectasia (GAL)

Publication date: Available online 8 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): H Hara, M Mihara
The purpose of this paper is to report on the relationship between lymphoscintigraphic findings and the operative results of lymphatico-venous anastomosis (LVA) and resection of genital acquired lymphangiectasia (GAL). Seventeen GAL patients who underwent lymphoscintigraphy between April 2012 and June 2016 were included in this retrospective study. LVA and GAL resections were performed for 14 patients. The GALs were resected in a spindle shape to the full thickness of the genital skin and the wounds were closed primarily. Following the procedure, we investigated the recurrence rate and compared the results with the lymphoscintigraphic findings. The average follow-up period was 19.2 months. Six patients were without recurrence and eight patients experienced a small recurrence of GAL. The average period from the operation to recurrence was 16.8 months (range: 1-41 months). In the six patients who had genital accumulation in lymphoscintigraphy, two experienced recurrence (33.3 %), while six of the eight patients without genital accumulation experienced recurrence (75.0 %). The frequency of cellulitis was observed to be reduced postoperatively in all patients, and recurrence was observed in one patient at 11 months postoperatively. In conclusion, lower limb LVA combined with genital skin tumor resection was effective for preventing recurrence of GAL in patients who demonstrated communication between the lymphatic vessels in the lower limb and the genitals. This procedure also had the benefit of reducing the frequency of cellulitis for an average of 19.2 months of follow-up.