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Lymphatic complications after harvesting venous conduits in coronary artery bypass grafting surgery

https://doi.org/10.29001/2073-8552-2021-36-3-27-34

Abstract

Complications associated with the disorders of lymphatic outflow in the lower extremities are common in cardiovascular surgery involving the isolation of venous conduits and interventions on the femoral vessels. Despite the relatively low frequency, treatment of these complications requires significant efforts and does not always yield the expected results whereas timely diagnosis of lymphatic drainage disorders is often difficult. This becomes the reason for repeated hospitalizations, surgical interventions, long hospital stays, and disabilities. However, the problem of lymphatic complications is still not getting enough attention. This article discusses the pathogenesis, predictors of lymphatic complications, and the options and approaches to their treatment and diagnosis.

About the Authors

D. V. Manvelyan
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

David V. Manvelyan, Cand. Sci. (Med.), Junior Research Scientist, Department of Cardiovascular Surgery.

111a, Kievskaya str., Tomsk, 634012



Yu. Y. Vechersky
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Siberian State Medical University
Russian Federation

Yury Y. Vechersky, Dr. Sci. (Med.), Professor, Leading Research Scientist, Department of Cardiovascular Surgery, Cardiology Research Institute, Tomsk NRMC RAS; Professor, Department of Hospital Surgery with the Course of Cardiovascular Surgery, Siberian SMU.

111a, Kievskaya str., Tomsk, 634012; 2, Moscovsky tract, Tomsk, 634050



V. V. Zatolokin
Научно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр, Российская академия наук
Russian Federation

Vasily V. Zatolokin, Cand. Sci. (Med.), Research Assistant, Department of Cardiovascular Surgery.

111a, Kievskaya str., Tomsk, 634012



M. S. Kuznetsov
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Siberian State Medical University
Russian Federation

Mikhail S. Kuznetsov, Cand. Sci. (Med.), Research Scientist, Department of Cardiovascular Surgery, Cardiology Research Institute, Tomsk NRMC RAS; Assistant Professor, Department of Hospital Surgery with the Course of Cardiovascular Surgery, Siberian SMU.

111a, Kievskaya str., Tomsk, 634012; 2, Moscovsky tract, Tomsk, 634050



B. N. Kozlov
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Siberian State Medical University
Russian Federation

Boris N. Kozlov, Dr. Sci. (Med.), Head of the Department of Cardiovascular Surgery, Cardiology Research Institute, Tomsk NRMC RAS; Professor, Department of Hospital Surgery with the Course of Cardiovascular Surgery, Siberian SMU.

111a, Kievskaya str., Tomsk, 634012; 2, Moscovsky tract, Tomsk, 634050



References

1. Lavrenyuk O.V., Chernyavsky A.M., Volkov A.M., Terekhov I.N., Nimaev V.V. The state of the lymphatic bed of the lower extremities after open and endoscopic isolation of the great saphenous vein during coronary artery bypass grafting. Angiology and Vascular Surgery. 2013;19(3):46– 51 (In Russ.).

2. Fuller J., Guderian D., Kohler C., Schneider A., Wendt T.G. Lymph edema of the lower extremities after lymphadenectomy and radiotherapy for cervical cancer. Strahlenther. Onkolog. 2008;184(4):206–211. DOI: 10.1007/s00066-008-1728.

3. Novikov R.V. Radioisotope lymphoscintigraphy in prostate cancer: А modern view of the problem. Experimental and Clinical Urology. 2017;(2):26–33 (In Russ.).

4. Boccardo F., Campisi C.C., Molinari L., Dessalvi S., Santi P.L., Camp isi C. Lymphatic complications in surgery: Possibility of prevention and therapeutic options. Updates Surg. 2012;64(3):211–216. DOI: 10.1007/s13304-012-0165-0.

5. Pittaluga P., Chastanet S. Lymphatic complications after varicose veins surgery: Risk factors and how to avoid them. Phlebology. 2012;27(1):139–142. DOI: 10.1258/phleb.2012.012s12.

6. Twine C.P., Lane I.F., Williams I.M. Management of lymphatic fistulas after arterial reconstruction in the groin. Ann. Vasc. Surg. 2013;27(8):1207– 1215. DOI: 10.1016/j.avsg.2013.01.003.

7. Athanasiou T., Aziz O., Al-Ruzzeh S., Philippidis P., Jones C., Purkayastha S. et al. Are wound healing disturbances and length of hospital stay reduced with minimally invasive vein harvest? A meta-analysis. Eur. J. Cardiothorac. Surg. 2004;26(5):1015–1026. DOI: 10.1016/j.ejcts.2004.07.013.

8. Vechersky Yu., Manvelyan D., Zatolokin V., Shipulin V., Kozlov B. A new endoscopic vein harvesting technique for coronary artery bypass surgery. The Doctor. 2019;30(4):28–34 (In Russ.). DOI: 10.29296/258773052019-04-05.

9. Raja S.G., Sarang Z. Endoscopic vein harvesting: technique, outcomes, concerns & controversies. J. Thorac. Dis. 2013;5(6):S630–637. DOI: 10.3978/j.issn.2072-1439.2013.10.01.

10. Piza-Katzer H., Pilz E. Distal external lymph fistula of the tibia as a complication of vena saphena magna harvesting. Vasa. 1992;21(1):85–86 (In German.).

11. Abai B., Zickler R.W., Pappas P.J., Lal B.K., Padberg F.T. Jr. Lymphorrhea responds to negative pressure wound therapy. J. Vasc. Surg. 2007;45(3):610–613. DOI: 10.1016/j.jvs.2006.10.043.

12. Molina J.E. Lymphocele after vein harvesting. In book: Cardiothoracic surgical procedures and techniques. Cham: Springer; 2018:63–66. DOI: 10.1007/978-3-319-75892-3_13.

13. Siddiqi M.S. Saphenous vein harvest wound complications: risk factors, identification, prevention, and management. Chronic Wound Care Management and Research. 2016;(3):147–156. DOI: 10.2147/CWCMR. S82601.

14. Belczak C.E., de Godoy J.M., Cruz J.A.F., Tyszca A.L., Neto H.J., Caffaro R.A. Lymphoscintigraphic findings: Delayed oedema after great saphenous vein harvesting. Phlebology. 2011;26(5):185–190. DOI: 10.1258/phleb.2010.010071.

15. Schacht V., Luedemann W., Abels C., von Rautenfeld D.B. Anatomy of the subcutaneous lymph vascular network of the human leg in relation to the great saphenous vein. Anat. Rec. (Hoboken). 2009;292(1):87–93. DOI: 10.1002/ar.20765.

16. Alekseev S.A., Koshevsky P.P. Lymphatic outflow disorders: lymphostasis, lymphedema: methodical manual. Minsk: BSMU; 2016:20 (In Russ.).

17. Singh N., Agarwal A. Lymphocele following saphenous vein harvesting. Ibnosina Journal of Medicine and Biomedical Sciences. 2011;3(5):188– 189. DOI: 10.4103/1947-489X.210892.

18. Zhukov B.N., Yarovenko G.V., Katorkin S.E., Myshentsev P.N. Modern aspects of conservative treatment of patients with lymphove nous insufficiency of the lower extremities. Grekov’s Bulletin Surgery. 2009;168(1):38–40 (In Russ.).

19. Watfa W., Campisi C., Ryan M., Matter M., Cherix S., Sörelius K. et al. Lymphatic leaks of the Thigh and Inguinal Region: Combined plastic surgery approaches for an effective treatment algorithm. Ann. Рlast. Surg. 2020;85(6):661–667. DOI: 10.1097/SAP.0000000000002310.

20. Cha J.G., Lee S.Y., Hong J., Ryeom H.K., Kim G.C., Do Y.W. Transpedal lymphatic embolization for lymphorrhea at the graft harvest site after coronary artery bypass grafting. Yeungnam Univ. J. Med. 2020;38(1):74– 77. DOI: 10.12701/yujm.2020.00297.

21. Kuznetsov M.S., Shipulin V.M., Kozlov B.N., Nasrashvili G.G., Panfilov D.S., Sonduev E.L. et al. Experience with combined method of air-plasma therapy in cardiac surgery. Clin. Experimen. Surg. Petrovsky J. 2020;8(2):73–82 (In Russ.). DOI: 10.33029/2308-1198-2020-8-2-73-82.

22. Minnebaev M.M., Mukhutdinova F.I., Tagirova D.R., Mukhutdinov D.A. Modern ideas about the functioning of the lymphatic system in health and disease. Kazan Medical Journal. 2006;87(1):43–47 (In Russ.).

23. Földi M., Földi Е. Földi’s textbook of lymphology: for physicians and lymphedema therapists; 3th edit. Munchen: Elsevier Health Sciences; 2012:657.

24. National guidelines on radionuclide diagnostics; edit. by Yu.B. Lishmanov, V.I. Chernov; in 2 vol., vol. 2. Томск: STT; 2010:418 (In Russ.).

25. Szuba A., Shin W.S., Strauss H.W., Rockson S. The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J. Nucl. Med. 2003;44(1):43–57.

26. Amosov V.I., Katsev V.M., Dmitrieva L.A., Lapekin S.V. Lymphoscintigraphy of the lower extremities: diagnostic capabilities of the methods. Regional Blood Circulation and Microcirculation. 2002;1(3):48–52 (In Russ.).

27. Vechersky Yu., Manvelyan D., Zatolokin V., Zavadovsky K., Sazonova S., Usov V. et al. The lower limb after coronary bypass surgery. The Doctor. 2019;30(6):53–59 (In Russ.). DOI: 10.29296/25877305-2019-06-1.

28. Francesco B., Corrado C., Giuseppe M., Emanuela B., Chiara B., Francesco P. et al. Prevention of lymphatic injuries in surgery. Microsurgery. 2010;30(4):261–265. DOI: 10.1002/micr.20735.


Review

For citations:


Manvelyan D.V., Vechersky Yu.Y., Zatolokin V.V., Kuznetsov M.S., Kozlov B.N. Lymphatic complications after harvesting venous conduits in coronary artery bypass grafting surgery. Siberian Journal of Clinical and Experimental Medicine. 2021;36(3):27-34. (In Russ.) https://doi.org/10.29001/2073-8552-2021-36-3-27-34

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ISSN 2713-265X (Online)