
==== Front
Plast Reconstr Surg Glob Open
Plast Reconstr Surg Glob Open
GOX
Plastic and Reconstructive Surgery Global Open
2169-7574
Lippincott Williams & Wilkins Hagerstown, MD

GOX-D-24-00774
00011
10.1097/01.GOX.0001063852.60948.6a
3
PSTM Abstract Supplement
PSTM Top Abstracts/Posters 2024
Eyelid Skin in Morbihan Disease is Pathologically Chronic Lymphedema and is an Indication for Super-microsurgical Lymphaticovenous Anastomosis
Akita Shinsuke MD, PhD 1
Kajiya Kentaro PhD 1
Gantumur Enkhtuul PhD 1
Nao Itai Kazuki Takagaki PhD 1
Mitsukawa Nobuyuki MD, PhD 1
Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University, Chiba, Japan
9 2024
18 9 2024
12 Suppl 8-9Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved.
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

OPEN-ACCESSTRUE
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pmcBACKGROUND: Super-microsurgical lymphaticovenous anastomosis (LVA) has been developed in the field of extreme lymphedema. We reported that the histological changes in the microlymphatic vessels of chronic lymphedema of the extremities depend on the degree of progression of the lymphedema, and that in irreversible advanced lymphedema, the junctions of lymphatic endothelium of the lymphatic capillaries are remodeled from discrete bouton-like structures to continuous zipper-like structures1. LVA may also be useful to treat eyelid lymphedema. The aim of the study was to test the therapeutic effect of LVA on eyelid edema in Morbihan disease and to determine whether pathological changes that could be considered chronic lymphedema of the skin occur.

METHODS: A retrospective case-control study was performed. Postoperative recurrence rates were compared between the patients who underwent debulking surgery plus LVA (study group) and the patients who underwent debulking surgery (control group) for Morbihan disease. The three-dimensional microstructures of the excised skin were pathologically compared with the eyelid skin without edema to determine whether they caused tissue changes that should be diagnosed as chronic lymphedema.

RESULT: No significant short-term complications occurred after surgery in either group. The recurrence rate within 1 year after surgery was significantly lower in the study group than in the control group (1/7 vs 5/6, respectfully, p = 0,03). Pathologically, patients with Morbihan disease showed signs of changes in the microstructure of capillary lymphatic in the dermis, which is characteristic of chronic lymphedema in advanced stage.

DISCUSSION: LVA reduced the risk of postoperative recurrence during debulking surgery in Morbihan disease with DBF on ICG angiography. The excised skin also developed pathological change that should be treated as in advanced-stage lymphedema. These clinical and pathological results suggested that debulking surgery plus LVA might be a suitable treatment option for Molbihan disease.

REFERENCES:

1. Itai N, Gantumur E, Tsujita-Inoue K, Mitsukawa N, Akita S, Kajiya K. Lymphangiogenesis and Lymphatic Zippering in Skin Associated with the Progression of Lymphedema. J Invest Dermatol. 2023. Online ahead of print.
