Author/Editor		Stritar, Bine
Title		Primjena peteljkastog ileomezenterijalnog transplantata u liječenju sekundarnog limfedema
Type		monografija
Place		Zagreb
Publisher		Sveučilište u Zagrebu, Medicinski fakultet
Publication year		1995
Volume		str. 57
Language		cro
Abstract		Surgical treatment of lymphedema using an enteromesenteric flap is one of several methods of the use of the bridging operation as a functional physiological procedure. There are different opinions about its convenience. By some authors this method is considered only as a historical procedure, others recognize it as an experimental method or even as a possible operation with encouraging results. Enteromesenteric bridge is used for the treatment of primary lymphedema in patients with dysplastic pelvic lymph nodes considered as a proximal variety of an idiopatic lymphedema. So far, this method has been experimentally examined on laboratory animals only "in situ" without previous induction of lymphedema. In the thesis the historical review outlines various possibilities of surgical treatments for lymphedema while no one proved to be dominant. The aim of our research was an analysis of convenience of ileomesenteric flap or the treatment of lymphedema previously induced. At first, the experimental research included two models - an induction of lymphedema and transposition of a short segment of the small bowel (ileum) with its mesentery intact. Then we found out that the flap was functional only when being implanted under skin coverage and not in dehiscency. Owing to a skin defect, caused by the lymphedema induction, the third model - skin flap coverage of the defect - was included. Under these conditions, the ingrowth of the flap into the surrounding tissue and a reduction of the lymphedema were achieved. Lymphedema stages were determined by a cicumference between a lymphedemic lower extremity and a healthy one. The average difference was 11,7 mm. The lymphedema was proved scintigraphically and lymphographically too. The small bowel (ileum) in a serie of eight rats was transposed to a lymphedemic extremity. (Abstracts truncated at 2000 characters)
Descriptors		LYMPHEDEMA LYMPH NODE EXCISION ILEUM MESENTERY RATS LYMPHOGRAPHY EXTREMITIES