LYMPHATIC DAMAGE IN VENOUS SURGERY

 
 
 

A. MACCIÒ 1-2, F. BOCCARDO 1, V. LA GANGA 2, R. LO GIUDICE 2, A. MONTOBBIO 2, C. CAMPISI

1) Department of Surgery – General Surgery, Lymphatic Surgery and Microsurgery

San Martino Hospital – University of Genoa, Italy

2) “Prevention, Diagnosis and Therapy of Lymphatic and Chyliferes Vessels Diseases” Ambulatory

Service of Lymphology – S.C. General Surgery – Ovada Hospital, ASL 22 Piedmont, Italy

Correspondence authors: francesco.boccardo@unige.it – campisi@unige.it

ABSTRACT

Purpose: Before a lower limb surgical operation due to venous

disease, it is necessary to immediately evaluate the presence and

seriousness of the concurrent lymphatic deficiency.

Methods: Besides objective test that can reveal a clinically

evident lymphatic deficiency, it is helpful to investigate family and

remote pathological anamnesis to identify possible risk factors or

specific family propensities. As far as instrumental tests are

concerned, it is advisable to perform both a doppler

ultrasonographic examination and a limb segmentary

Lymphoscintigraphy. The most risky area is the inguinal one,

where lymphatic collector vessels join main lymph-nodal

structures. Obviously, lesions of these structures may start a

lymphatic deficiency, but it is also important to underline that scar

reactions and relevant fibrosis, that may characterize an even

normal post-operation period, may create a further obstacle to

normal lymphatic drain.

Results and Conclusions: Special attention has to be paid to

precise indications and venous surgery technique in mixed clinical

situations, when both venous and lymphatic systems are involved,

to avoid potential clinical state worsening. Finally, diagnostic and

therapeutical prevention modalities for possible lymphatic injuries

in CVI affected limbs have to be kept into consideration, up to

microsurgical technique application. Hopefully therefore, with the

purpose of a correct preventive and not invasive surgical

operation, more an more buy Lasix online attention will be paid regarding potential

lymphatic impairment derived from venous surgery.