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A new technique of microlympho-venous anastomoses. Experimental study.

This experimental study in dogs presents a new technique of microlympho-venous anastomosis to improve long-term patency rates and clinical results in lymphedema therapy. Technical points, such as an oval window on the wall of the vein and a few sutures piercing only two lymphatic layers, adventitia and media, outside the lumen for successful results are emphasized. Three methods for assessment of patency of anastomoses were used: (1) observation with operating microscope of dye transit across the anastomotic site; (2) lymphography, and (3) histopathologic examination. Of 23 dogs, five were used to perfect the technique, three died after operation, while the remaining 15 were divided into three groups of five dogs each. In the first group which were explored one month after surgery, all anastomoses were patent (100% patency). In the second group, explored three months after surgery, one anastomosis was obstructed and four were patent (80% patency). In the third group, explored six months after surgery, one anastomosis was obstructed and four were patent (80% patency). The results obtained with this technique and the occurrence of a similar physiological lympho-venous anastomosis suggest that end-to-side anastomosis may be the technique of choice.