Supramicrosurgical lymphatic-venous anastomosis for postsurgical subcutaneous lymphocele treatment

Postsurgical subcutaneous lymphocele is caused by accidental lesion of a lymphatic vessel that keeps on flowing lymph under the scar. Traditional treatments include aspiration and compression, with probable recurrence, and sclerotherapy which destroys both lymphatic cyst and vessel, creating risk of lymphedema. We describe the case of a postsurgical subcutaneous lymphocele of the left leg that was treated by supramicrosurgical lympatic-venous anastomosis. A single anastomosis was performed end-to-end, between one lymphatic vessel, individuated through indocyanine green lymphography, and one subcutaneous vein, distally to the lymphocele, under sedation and local anesthesia. Postoperative course was uneventful; the lymphocele completely resolved and never recurred during the nine months followup. This technique may heal the lymphocele with no impairing of lymph drainage function.