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Chen et al. Plast Aesthet Res 2021;8:36 Plastic and
DOI: 10.20517/2347-9264.2021.33
Aesthetic Research

Original Article Open Access

Lymphovenular anastomosis under local anesthesia
for the patients at higher ASA PS score: benefits and

results

1,2
2
1
Chun-Chia Chen , Chi-Chung Chen , Shun-Fa Yang , Chi-Chang Chang 3
1
Institute of Medicine, Chung Shan Medical University, Taichung City 40201, Taiwan.
2
Department of Plastic Surgery, Chung Shan Medical University Hospital, Taichung City 40201, Taiwan.
3
Department of Medical Informatics, Chung Shan Medical University Hospital, Taichung City 40201, Taiwan.
Correspondence to: Dr. Chun-Chia Chen, Institute of Medicine, Chung Shan Medical University, No.110, Sec. 1, Jianguo North
Road, Taichung City 40201, Taiwan. E-mail: chenjica@gmail.com
How to cite this article: Chen CC, Chen CC, Yang SF, Chang CC. Lymphovenular anastomosis under local anesthesia for the
patients at higher ASA PS score: benefits and results. Plast Aesthet Res 2021;8:36. https://dx.doi.org/10.20517/2347-
9264.2021.33

Received: 14 Apr 2021 First Decision: 14 May 2021 Revised: 3 Jun 2021 Accepted: 29 Jun 2021 First online: 5 Jul 2021
Academic Editors: Matthew L Iorio, Isao Koshima Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Aim: To evaluate the effectiveness of lymphovenular anastomosis (LVA) under local anesthesia for patients with
high American Society of Anesthesiologists Physical Status (ASA PS) score.

Methods: From January 2019 to January 2021, we collected a total of 29 patients with lymphedema stage III and
IV, operated upon with LVA by a single surgeon in a medical center. These patients had poor responses to
compression therapies. After surgery, the patients underwent complex decongestive therapy consisting of the
continuous wearing of an elastic stocking. To examine the effect of LVA, all data were collected, and differences in
preoperative and postoperative means were analyzed.

Results: Twenty-nine patients with high ASA PS score (> 3) were followed after lymphovenular anastomosis and
postoperative compression therapies. Twenty-one of 29 patients were survivors of oncological diseases and
continued oncological therapies. The average duration of edema of these patients before LVA was 25 ± 5.0 years.
The average number of anastomosis for each patient was 6.8 ± 2.2; the methods of anesthesia had no significant
influence on these numbers. The average follow-up period was 7.8 ± 0.85 months, and the result was considered
effective (26/29 patients; 89.7%). The average reduction of the circumference in affected limbs was 4.40% ±
3.67% of the preoperative excess length. There were no perioperative complications in this study.

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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