Prospective Experimental Study of Microvascular Reconstruction in Lymphedema

Microsurgical approaches to human lymphedema continue to enjoy ever-increasing utilization. However, historically, the therapeutic outcomes have at times remained disappointing. Methodology to evaluate the therapeutic impact of these interventions has not been widely available. In addition, mechanistic animal-based studies have generally not been employed.

In the current issue of Lymphatic Research and Biology, Fernández Peñuela propose a new, useful model for the experimental study of microvascular reconstruction. They surgically induced unilateral lymphedema in the ears of New Zealand white rabbits, with observed lymphedema that was established by postsurgical day 15. Thereafter, terminal lymphaticovenous anastomosis was established, allowing postsurgical comparison to the contralateral ear. They utilized transauricular tissue thickness as a measure of the lymphedema response to intervention, demonstrating a statistically significant improvement by postoperative day 15. They also performed immunohistochemical analysis of the lymphatic microvasculature; however, in this short-term postoperative investigation, no structural changes were observed.

The study is notable for providing a context in which to investigate the mechanistic impact of surgical intervention. Further exploration of this and similar models should provide a platform for assessing the longer term response of chronic lymphedema to surgical intervention.