© 2010 Wiley-Liss, Inc. Microsurgery 30:339–347, 2010. “
“Lymphaticovenular anastomosis (LVA) is a useful treatment for compression-refractory lymphedema with its effectiveness and minimal invasiveness. However, LVA requires supermicrosurgery, where lymphatic vessels with a diameter of 0.5 mm or smaller are anastomosed using 11-0 or 12-0 suture. To make LVA easier and safer, we adopted a modified side-to-end (S-E) anastomosis in LVA surgery. We performed modified S-E LVAs in 14 limbs Romidepsin solubility dmso of female patients with lower extremity

lymphedema (LEL). In modified S-E LVA, lateral windows with a length of 1.0 mm or longer were created on a lymphatic vessel and a vein, respectively, and side-to-side (S-S) anastomosis was established with 10-0 continuous suture. After completion of S-S anastomosis, the vein distal to the anastomosis site was ligated to prevent venous backflow and subsequent thrombosis at the anastomosis site. Lymphedematous volume was evaluated preoperatively and at postoperative 6 months using LEL index. All the 24 modified S-E anastomoses could be completed without

difficulty or revision for anastomosis, and showed good patency after completion of anastomosis. Postoperatively, LEL indices significantly decreased compared with preoperative LEL index (255.9 ± 14.1 vs. 274.9 ± 22.2, P < 0.001). Modified S-E LVA can efficaciously divert lymph flows into venous circulation without performing supermicrosurgical anastomosis. © 2012 Wiley Periodicals, Inc., Microsurgery, 2013. "
“Functional reconstruction of the anterior mandibular Protirelin defect in combination Selleckchem Temsirolimus with a significant glossectomy is a challenging problem for reconstructive micro-surgeons. In this retrospective study, clinical results were compared between mandibular reconstruction plate (MRP) procedures and double flap transfers. The subjects were 23 patients who underwent immediate reconstruction, after an anterior segmental mandibulectomy in combination with a significant glossectomy, from 1993 to 2009. The patients were

divided into two groups based on the reconstructive methods used: MRP and soft tissue free flap transfer (MRP group: 12 patients) or double free flap transfer (double flap group: 11 patients). Operative stress, postoperative complications and oral intake ability were compared between the groups. The rate of recipient-site complication in the double flap group tended to be lower than that in the MRP group. The most frequent complications in the MRP group included infection and orocutaneous fistula. Operative stresses (operation time and blood loss) were significantly less in the MRP group than in the double flap group. Overall, 19 patients (82.6%) were able to tolerate an oral diet without the need for tube feeding. This study demonstrates that laryngeal preservation is possible in more than 80% of patients even after such an extensive ablation.