形成外科医になって間もない頃、リンパ管静脈吻合術を受けた患者さんの足が、すっと柔らかくなり、細くなっていくのを見て、感動しました。たった0.5mmのリンパ管に未知数の魅力を感じ、今までリンパ浮腫診療を行ってきました。がんの治療を乗り越えたみなさんが、少しでもハッピーに、リンパ浮腫のことを忘れて毎日を過ごせるように、サポートしていきたいと思っています。リンパ浮腫の治療は、保存療法だけではうまくいかないこともあり、手術だけでもうまくいきません。たくさんの熱意あるリンパ浮腫セラピストたちと一緒に、日々よりよい治療を目指して奮闘しています。私自身も、毎日弾性ストッキングをはき、夜には弾性包帯を巻き、日々を過ごしています。海外旅行に行きたい、仕事を続けたい、マラソンがしたい、いつまでも自分の足で歩きたいという願いをあきらめず、まずはご相談ください。

【これまでに発表した学術論文】

   First author

  1. Hara H, Mihara M. Usefulness of preoperative echography for detection of lymphatic vessels for lymphaticovenous anastomosis. SAGE Open Med Case Rep. 2017 Dec 7;5:2050313X17745207.
  2. Hara H, Mihara M. Indocyanine Green Lymphographic and Lymphoscintigraphic Findings in Genital Lymphedema-Genital Pathway Score. Lymphat Res Biol. 2017 Sep 29.
  3. Hara H, Mihara M. Blocking of the Lymphatic Vessel in Lymphedema. Eplasty. 2017 Mar 27;17:e11. eCollection 2017.

  4. Hara H, Mihara M, Kyoko Hasegawa, Kazuko Yamanaka. Lymphatic dysfunction after ligation 
    surgery for varicose vein. SAGE Open Medical Case Report. 2016;4:1-4.

  5. Hara H, Mihara M, Anan T, Fukumoto T, Narushima M, Iida T, Koshima I. Pathological Investigation of Acquired Lymphangiectasia Accompanied by Lower Limb Lymphedema: Lymphocyte Infiltration in the Dermis and Epidermis. Lymphat Res Biol. 2016 Sep;14(3):172-80.
  6. Hara H, Mihara M, Ohtsu H, Narushima M, Iida T, Koshima I. Indication of Lymphaticovenous Anastomosis for Lower Limb Primary Lymphedema. Plast Reconstr Surg. 2015 Oct;136(4):883-93.

  7. Hara H, Mihara M, Seki Y, Todokoro T, Iida T, Koshima I. Comparison of indocyanine green lymphographic findings with the conditions of collecting lymphatic vessels of limbs in patients with lymphedema. Plast Reconstr Surg. 2013 Dec;132(6):1612-8.

  8. Hara H, Mihara M, Seki Y, Koshima I. Lymphoedema caused by idiopathic lymphatic thrombus. J Plast Reconstr Aesthet Surg. 2013 Dec;66(12):1780-3.

  9. Hara H, Mihara M, Okuda I, Hirota A, Narushima M, Iida T, Yamamoto T, Todokoro T, Koshima I. Presence of thoracic duct abnormalities in patients with primary lymphoedema of the extremities. J Plast Reconstr Aesthet Surg. 2012 Nov;65(11):e305-10.

  10. Hara H, Mihara M, Narushima M, Iida T, Todokoro T, Yamamoto T, Okuda I, Koshima I. Idiopathic portal hypertension and lower limb lymphedema. Lymphology. 2012 Jun;45(2):63-70.

  11. Hara H, Mihara M, Iida T, Narushima M, Koshima I. Blood glucose measurement in flap monitoring for salvage of flaps from venous thrombosis. Plast Reconstr Surg. 2012 Mar;129(3):587e-589e.

  12. Hara H, Mihara M, Iida T, Narushima M, Todokoro T, Yamamoto T, Koshima I. Blood glucose measurement for flap monitoring to salvage flaps from venous thrombosis. J Plast Reconstr Aesthet Surg. 2012 May;65(5):616-9.

  13. Hara H, Mihara M, Narushima M, Yamamoto T, Todokoro T, Araki J, Iida T, Koshima I, Shim TW. Flap salvage following postoperative venous thrombosis diagnosed by blood glucose measurement in the flaps. Eplasty. 2011;11:e28. Epub 2011 Jun 22.

  14. Hara H, Koshima I, Okuda I, Narushima M, Mihara M, Todokoro T. Assessment of configuration of thoracic duct using magnetic resonance thoracic ductography in idiopathic lymphedema. Ann Plast Surg. 2012 Mar;68(3):300-2.

  15.  Hara H, Mihara M, Anan T, Fukumoto T, Narushima M, Iida T, Koshima I. Pathological investigation of acquired lymphangiectasia accompanied by lower limb lymphedema: lymphocyte infiltration in the dermis and epidermis. Lymphat Res Biol. In press.

Co-authour 

   *: equal contribution

  1. Mihara M, Hara H*, Kawakami Y, Zhou HP, Tange S, Kikuchi K, Iida T. Multi-site lymphatic venous anastomosis using echography to detect suitable subcutaneous vein in severe lymphedema patients. J Plast Reconstr Aesthet Surg. 2017 Oct 17. pii: S1748-6815(17)30409-6.
  2. Mihara M, Hara H*, Kikuchi K. Lymph node transfer for refractory infectious sites caused by trauma. SAGE Open Med Case Rep. 2017 Jun 2;5:2050313X17711631.
  3. Mihara M, Hara H*, Zhou HP, Tange S, Kikuchi K. Lymphaticovenous Anastomosis Releases the Lower Extremity Lymphedema-associated Pain. Plast Reconstr Surg Glob Open. 2017 Jan 26;5(1):e1205.
  4. Mihara M*, Hara H*, Tsubaki H, Suzuki T, Yamada N, Kawahara M, Murai N. Combined conservative treatment and lymphatic venous anastomosis for severe lower limb lymphedema with recurrent cellulitis. Ann Vasc Surg. 2015 Aug;29(6):1318.e11-5.
  5. Mihara M*, Hara H*, Shibasaki J, Seki Y, Hayashi A, Iida T, Adachi S, Uchida Y, Kaneko H, Haragi M, Murakami A. Indocyanine green lymphography and lymphaticovenous anastomosis for generalized lymphatic dysplasia with pleural effusion and ascites in neonates. Ann Vasc Surg. 2015 Aug;29(6):1111-22.

  6. Mihara M*, Hara H*, Todokoro T, Seki Y, Iida T, Koshima I, Murai N. The effect of lymphatico-venous anastomosis for an intractable ulcer at the lower leg in a marked obese patient. Microsurgery. 2014 Jan;34(1):64-7.

  7. Mihara M*, Hara H*, Araki J, Narushima M, Iida T, Koshima I. Treatment of hand lymphedema with free flap transfer and lymphangiogenesis analysis after hand replantation using indocyanine green (ICG) lymphography and histological analysis. J Plast Reconstr Aesthet Surg. 2013 Nov;66(11):e338-40.

  8. Mihara M*, Hara H*, Narushima M, Mitsui K, Murai N, Koshima I. Low-invasive lymphatic surgery and lymphatic imaging for completely healed intractable pudendal lymphorrhea after gynecologic cancer treatment. J Minim Invasive Gynecol. 2012 Sep-Oct;19(5):658-62.

  9. Mihara M*, Hara H*, Hayashi Y, Narushima M, Yamamoto T, Todokoro T, Iida T, Sawamoto N, Araki J, Kikuchi K, Murai N, Okitsu T, Kisu I, Koshima I. Pathological steps of cancer-related lymphedema: histological changes in the collecting lymphatic vessels after lymphadenectomy. PLoS One. 2012;7(7):e41126.

  10. Mihara M*, Hara H*, Iida T, Todokoro T, Yamamoto T, Narushima M, Tashiro K, Murai N, Koshima I. Antegrade and retrograde lymphatico-venous anastomosis for cancer-related lymphedema with lymphatic valve dysfuction and lymphatic varix. Microsurgery. 2012 Oct;32(7):580-4.

  11. Mihara M*, Hara H*, Kikuchi K, Yamamoto T, Iida T, Narushima M, Araki J, Murai N, Mitsui K, Gennaro P, Gabriele G, Koshima I. Scarless lymphatic venous anastomosis for latent and early-stage lymphoedema using indocyanine green lymphography and non-invasive instruments for visualising subcutaneous vein. J Plast Reconstr Aesthet Surg. 2012 Nov;65(11):1551-8.

  12. Mihara M*, Hara H*, Araki J, Kikuchi K, Narushima M, Yamamoto T, Iida T, Yoshimatsu H, Murai N, Mitsui K, Okitsu T, Koshima I. Indocyanine green (ICG) lymphography is superior to lymphoscintigraphy for diagnostic imaging of early lymphedema of the upper limbs. PLoS One. 2012;7(6):e38182.

  13. Mihara M*, Kisu I*, Hara H*, Iida T, Araki J, Shim T, Narushima M, Yamamoto T, Moriguchi H, Kato Y, Tonsho M, Banno K, Aoki D, Suganuma N, Kagawa N, Takehara Y, Kato O, Koshima I. Uterine autotransplantation in cynomolgus macaques: the first case of pregnancy and delivery. Hum Reprod. 2012 Aug;27(8):2332-40.

  14. Mihara M*, Hara H*, Hayashi Y, Iida T, Araki J, Yamamoto T, Todokoro T, Narushima M, Murai N, Koshima I. Upper-limb lymphedema treated aesthetically with lymphaticovenous anastomosis using indocyanine green lymphography and noncontact vein visualization. J Reconstr Microsurg. 2012 Jun;28(5):327-32.

  15. Mihara M*, Iida T*, Hara H*, Hayashi Y, Yamamoto T, Narushima M, Hayami S, Sawamoto N, Naito M, Koshima I. Autologus groin lymph node transfer for “sentinel lymph network” reconstruction after head-and-neck cancer resection and neck lymph node dissection: a case report. Microsurgery. 2012 Feb;32(2):153-7.

  16. Mihara M*, Hara H*, Narushima M, Hayashi Y, Yamamoto T, Oshima A, Kikuchi K, Murai N, Koshima I. Lower limb lymphedema treated with lymphatico-venous anastomosis based on pre- and intraoperative icg lymphography and non-contact vein visualization: A case report. Microsurgery. 2012 Mar;32(3):227-30.

  17. Karakawa R, Narushima M, Ogishima S, Hara H, et al. Free anterolateral thigh full-thickness skin flap with vascularized lateral femoral cutaneous nerve for the reconstruction of facial nerve and external auditory canal after the resection of facial nerve schwannoma. SAGE Open Med Case Rep. 2017 Nov 16;5:2050313X17741825.
  18. Chen WF, Zhao H, Yamamoto T, Hara H, Ding J. Indocyanine Green Lymphographic Evidence of Surgical Efficacy Following Microsurgical and Supermicrosurgical Lymphedema Reconstructions. J Reconstr Microsurg. 2016 Nov;32(9):688-698. Epub 2016 Aug 3.
  19. Narushima M, Iida T, Kaji N, Yamamoto T, Yoshimatsu H, Hara H, Kikuchi K, Araki J, Yamashita S, Koshima I. Superficial circumflex iliac artery pure skin perforator-based superthin flap for hand and finger reconstruction. J Plast Reconstr Aesthet Surg. 2016 Mar 26.
  20. Mihara M, Hara H. Priority Claim to "Sentinel Lymph Node Transfer". Arch Plast Surg. 2015 Nov;42(6):788. doi: 10.5999/aps.2015.42.6.788. Epub 2015 Nov 16.

  21. Koshima I, Narushima M, Mihara M, Yamamoto T, Hara H, Ohshima A, Kikuchi K, Todokoro K, Seki Y, Iida T, Nakagawa M. Lymphadiposal Flaps and Lymphaticovenular Anastomoses for Severe Leg Edema: Functional Reconstruction for Lymph Drainage System. J Reconstr Microsurg. 2016 Jan;32(1):50-5.

  22. Kisu I, Banno K, Mihara M, Hara H, Umene K, Adachi M, Nogami Y, Aoki D. A surgical technique using the ovarian vein in non-human primate models of potential living-donor surgery of uterus transplantation. Acta Obstet Gynecol Scand. 2015 Sep;94(9):942-8.

  23. Mihara M, Tange S, Hara H, Han Peng Z, Haragi M, Muarai N. Modified lymph vessel flap transplantation for the treatment of refractory lymphedema: A case report. Microsurgery. 2015 Mar 6.

  24. Todokoro T, Hara H, Yamamoto T, Koshima I. A threader technique using an 11-0 loop needle for supermicrosurgery. Microsurgery. 2015 Nov;35(8):672-3.

  25. Iida T, Yoshimatsu H, Tashiro K, Hara H, Yamamoto T, Narushima M, Koshima I. Reconstruction of a full-thickness, complex nasal defect that includes the nasal septum using a free, thin superficial inferior epigastric artery flap. Microsurgery. 2016 Jan;36(1):66-9.

  26. Mihara M, Zhou HP, Hara H, Tange S, Haragi M. Case report: a new hybrid surgical approach for treating mosaic pattern secondary lymphedema in the lower extremities. Ann Vasc Surg. 2014 Oct;28(7):1798.e1-6.

  27. Kisu I, Mihara M, Banno K, Hara H, Masugi Y, Araki J, Iida T, Yamada Y, Kato Y, Shiina T, Suganuma N, Aoki D. Uterus allotransplantation in cynomolgus macaque: a preliminary experience with non-human primate models. J Obstet Gynaecol Res. 2014 Apr;40(4):907-18.

  28. Shibasaki J, Hara H, Mihara M, Adachi S, Uchida Y, Itani Y. Evaluation of lymphatic dysplasia in patients with congenital pleural effusion and ascites using indocyanine green lymphography. J Pediatr. 2014 May;164(5):1116-1120.

  29. Iida T, Narushima M, Hara H, Yamamoto T, Yoshimatsu H, Morizaki Y, Uehara K, Koshima I. Supermicrosurgical free sensate intercostal artery perforator flap based on the lateral cutaneous branch for plantar reconstruction. J Plast Reconstr Aesthet Surg. 2014 Jul;67(7):995-7.

  30. Onoda S, Todokoro T, Hara H, Azuma S, Goto A. Minimally invasive multiple lymphaticovenular anastomosis at the ankle for the prevention of lower leg lymphedema. Microsurgery. 2014 Jul;34(5):372-6.

  31. Iida T, Narushima M, Yoshimatsu H, Mihara M, Kikuchi K, Hara H, Yamamoto T, Araki J, Koshima I. Versatility of lateral cutaneous branches of intercostal vessels and nerves: anatomical study and clinical application. J Plast Reconstr Aesthet Surg. 2013 Nov;66(11):1564-8.

  32. Kisu I, Mihara M, Banno K, Umene K, Araki J, Hara H, Suganuma N, Aoki D. Risks for donors in uterus transplantation. Reprod Sci. 2013 Dec;20(12):1406-15.

  33. Iida T, Yoshimatsu H, Hara H, Mihara M, Koshima I. Reconstruction of large facial defects using a sensate superficial circumflex iliac perforator flap based on the lateral cutaneous branches of the intercostal nerves. Ann Plast Surg. 2014 Mar;72(3):328-31.

  34. Narushima M, Iida T, Kadono T, Hara H, Yamamoto Y, Todokoro T, Mihara M, Koshima I. Free concha flap for sensitive nasal reconstruction using the infraorbital artery and nerve as a recipient vessel and a recipient nerve. Microsurgery. 2013 May;33(4):311-4.

  35. Chan VS, Narushima M, Hara H, Yamamoto T, Mihara M, Iida T, Koshima I. Local anesthesia for lymphaticovenular anastomosis. Ann Plast Surg. 2014 Feb;72(2):180-3.

  36. Mihara M, Hara H, Narushima M, Todokoro T, Iida T, Ohtsu H, Murai N, Koshima I. Indocyanine green lymphography is superior to lymphoscintigraphy in imaging diagnosis of secondary lymphedema of the lower limbs. J Vasc Surg Venous Lymphat Disord. 2013 Apr;1(2):194-201

  37. Mihara M, Seki Y, Hara H, Iida T, Oka A, Kikuchi K, Narushima M, Haragi M, Furniss D, Hin-Lun L, Mitsui K, Murai N, Koshima I. Predictive lymphatic mapping: a method for mapping lymphatic channels in patients with advanced unilateral lymphedema using indocyanine green lymphography. Ann Plast Surg. 2014;72(6):706-10

  38. Mihara M, Hayashi Y, Hara H, Iida T, Narushima M, Yamamoto T, Todokoro T, Murai N, Koshima I. High-accuracy diagnosis and regional classification of lymphedema using indocyanine green fluorescent lymphography after gynecologic cancer treatment. Ann Plast Surg. 2014 Feb;72(2):204-8.

  39. Yamamoto T, Narushima M, Yoshimatsu H, Seki Y, Yamamoto N, Oka A, Hara H, Koshima I. Minimally invasive lymphatic supermicrosurgery (MILS): indocyanine green lymphography-guided simultaneous multisite lymphaticovenular anastomoses via millimeter skin incisions. Ann Plast Surg. 2014 Jan;72(1):67-70.

  40. Todokoro T, Furniss D, Oda K, Kawana K, Narushima M, Mihara M, Kikuchi K, Hara H, Yano T, Koshima I. Effective treatment of pelvic lymphocele by lymphaticovenular anastomosis. Gynecol Oncol. 2013 Feb;128(2):209-14.

  41. Iida T, Mihara M, Yoshimatsu H, Hara H, Narushima M, Koshima I. Versatility of a near-infrared vein visualization device in plastic and reconstructive surgery. Plast Reconstr Surg. 2012 Oct;130(4):636e-638e.

  42. Iida T, Mihara M, Yoshimatsu H, Hara H, Koshima I, Kawai K, Tsuchiya T, Asakage T. Reconstruction of an extensive anterior skull base defect using a muscle-sparing rectus abdominis myocutaneous flap in a 1-year-old infant. Microsurgery. 2012 Nov;32(8):622-6.

  43. Kisu I, Banno K, Mihara M, Lin LY, Tsuji K, Yanokura M, Hara H, Araki J, Iida T, Abe T, Kouyama K, Suganuma N, Aoki D. Indocyanine green fluorescence imaging for evaluation of uterine blood flow in cynomolgus macaque. PLoS One. 2012;7(4):e35124.

  44. Iida T, Mihara M, Narushima M, Yoshimatsu H, Hara H, Koshima I. Preexcisional artery reconstruction: a new strategy in multiple hepatic artery reconstruction for reducing ischemic injury of the liver. Microsurgery. 2012 Sep;32(6):493-6.

  45. Iida T, Mihara M, Narushima M, Todokoro T, Hara H, Yoshimatu H, Koshima I, Kadono T. Dynamic reconstruction of full-thickness abdominal wall defects using free innervated vastus lateralis muscle flap combined with free anterolateral thigh flap. Ann Plast Surg. 2013 Mar;70(3):331-4.

  46. Mihara M, Hayashi Y, Hara H, Todokoro T, Koshima I, Murai N. Lymphatic-venous anastomosis for the radical cure of a large pelvic lymphocyst. J Minim Invasive Gynecol. 2012 Jan-Feb;19(1):125-7.

  47. Mihara M, Iida T, Hara H, Hayashi Y, Yamamoto T, Mitsunaga N, Todokoro T, Uchida G, Koshima I. Reconstruction of the larynx and aryepiglottic fold using a free radial forearm tendocutaneous flap after partial laryngopharyngectomy: a case report. Microsurgery. 2012 Jan;32(1):50-4.

  48. Mihara M, Murai N, Hayashi Y, Hara H, Iida T, Narushima M, Todokoro T, Uchida G, Yamamoto T, Koshima I. Using indocyanine green fluorescent lymphography and lymphatic-venous anastomosis for cancer-related lymphedema. Ann Vasc Surg. 2012 Feb;26(2):278.e1-6.

  49. Narushima M, Yamasoba T, Iida T, Yamamoto T, Yoshimatsu H, Hara H, Oshima A, Todokoro T, Kikuchi K, Araki J, Mihara M, Koshima I. Pure skin perforator flap for microtia and congenital aural atresia using supermicrosurgical techniques. J Plast Reconstr Aesthet Surg. 2011 Dec;64(12):1580-4

  50. Mihara M, Kisu I, Hara H, Iida T, Yamamoto T, Araki J, Hayashi Y, Moriguchi H, Narushima M, Banno K, Suganuma N, Aoki D, Koshima I. Uterus autotransplantation in cynomolgus macaques: intraoperative evaluation of uterine blood flow using indocyanine green. Hum Reprod. 2011 Nov;26(11):3019-27.

  51. Yamamoto T, Yamamoto N, Hara H, Mihara M, Narushima M, Koshima I. Upper extremity lymphedema index: a simple method for severity evaluation of upper extremity lymphedema. Ann Plast Surg. 2013 Jan;70(1):47-9.

  52. Mihara M, Murai N, Hayashi Y, Moriguchi H, Iida T, Hara H, Yamamoto T, Narushima M, Uchida G, Koshima I. Popliteal lymphatico-venous anastomosis for lower limb lymphedema to allow patients to adopt the traditional Japanese "seiza" sitting position. J Plast Reconstr Aesthet Surg. 2011 Nov;64(11):1544-6.

  53. Mihara M, Hayashi Y, Hara H, Iida T. Early lymph-drainage massage using a cosmetic roller after lymphatico-venous anastomosis compared to manual lymph drainage: a case report. J Plast Reconstr Aesthet Surg. 2011 Dec;64(12):1709-11

  54. Kisu I, Mihara M, Banno K, Hara H, Yamamoto T, Araki J, Iida T, Hayashi Y, Moriguchi H, Aoki D. A new surgical technique of uterine auto-transplantation in cynomolgus monkey: preliminary report about two cases. Arch Gynecol Obstet. 2012 Jan;285(1):129-37

  55. Mihara M, Uchida G, Hara H, Hayashi Y, Moriguchi H, Narushima M, Iida T, Yamamoto T, Koshima I. Lymphaticovenous anastomosis for facial lymphoedema after multiple courses of therapy for head-and-neck cancer. J Plast Reconstr Aesthet Surg. 2011 Sep;64(9):1221-5.