Complete Reduction of Lymphoedema of the Arm by Liposuction After Breast Cancer

Brorson, Håkan; Svensson, Henry

doi:10.3109/02844319709085480

Cited by 166 publications

(156 citation statements)

References 12 publications

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“…22,27,28 These volume reductions are much lower than the 87-111 % reductions we achieved with SAPL in chronic lymphedema patients, consistent with previously reported results for this procedure. 29 The safety of SAPL has been established and found not to further damage the already impaired lymphatic flow. 30 Although the procedure effectively removes excess volume and decreases infection risk, the technique does not address the pathophysiology causing the lymphedema.…”

Section: Discussionmentioning

confidence: 99%

An Effective System of Surgical Treatment of Lymphedema

et al. 2014

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Background. Effective surgical treatments for lymphedema now can address the fluid and solid phases of the disease process. Microsurgical procedures, including lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT), target the fluid component that predominates at earlier stages of the disease. Suctionassisted protein lipectomy (SAPL) addresses the solid component that typically presents later as chronic, nonpitting lymphedema of an extremity. We assess the outcomes of patients who underwent selective application of these three surgical procedures as part of an effective system to treat lymphedema. Methods. This is a retrospective chart review of patients with lymphedema who underwent complete decongestive therapy followed by surgical treatment with SAPL, LVA, or VLNT. The primary outcomes measured were postoperative volume reduction (SAPL), daily requirement for compression garments and lymphedema therapy (VLNT and LVA), and the incidence of severe cellulitis. Results. Twenty-six patients were included in the study, of which 10 underwent SAPL and 16 underwent LVA or VLNT. The average reduction of excess volume by SAPL was 3,212 mL in legs and 943 mL in arms, or a volume reduction of 87 and 111 %, respectively, when compared with the unaffected, opposite sides. Microsurgical procedures (VLNT and LVA) significantly reduced the need for both compression garment use (p = 0.003) and lymphedema therapy (p \ 0.0001). The overall rate of cellulitis decreased from 58 % before surgery to 15 % after surgery (p \ 0.0001).Conclusions. When applied appropriately to properly selected patients, surgical procedures used in the treatment of lymphedema are effective and safe.Lymphedema in the developed world commonly occurs after lymph node dissection and/or radiotherapy to nodal basins for breast cancer, melanoma, or gynecologic malignancies. Less commonly, lymphedema occurs as a result of congenital causes.

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Section: Discussionmentioning

confidence: 99%

An Effective System of Surgical Treatment of Lymphedema

et al. 2014

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“…This has led to the development of circumferential suction-assisted lipectomy as a treatment for lymphedema in cases in which fat hypertrophy dominates and fluid is minimal (37,38).…”

Section: Fat and Lymphaticsmentioning

confidence: 99%

New developments in clinical aspects of lymphatic disease

Mortimer¹,

Rockson²

2014

J. Clin. Invest.

287

232

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The lymphatic system is fundamentally important to cardiovascular disease, infection and immunity, cancer, and probably obesity -the four major challenges in healthcare in the 21st century. This Review will consider the manner in which new knowledge of lymphatic genes and molecular mechanisms has demonstrated that lymphatic dysfunction should no longer be considered a passive bystander in disease but rather an active player in many pathological processes and, therefore, a genuine target for future therapeutic developments. The specific roles of the lymphatic system in edema, genetic aspects of primary lymphedema, infection (cellulitis/erysipelas), Crohn's disease, obesity, cancer, and cancer-related lymphedema are highlighted.

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“…However, measurements are highly biased by variations in the degree of firmness and the contour of the limb, by the tension placed on it by the tape measure, or by the fact that the swelling of the soft tissue is not uniform (5). The water displacement method of assessing arm volume is much more reliable (57,58) as it measures the arm edema volume directly in milliliters. As in this study, both arms should be measured simultaneously so that the arm edema volume can be monitored, with the contralateral arm serving as a control, thus avoiding the effect of casual variations in the general body mass.…”

Section: Volume Measurementsmentioning

confidence: 99%

“…The displaced water was weighed on a balance to the nearest 5 g, corresponding to 5 ml. Both arms were always measured at each visit, and the difference in arm volumes was designated as the edema volume (57,58). The decrease in the edema volume was also calculated in percent, thus:…”

Section: Arm 6olume Measurementsmentioning

confidence: 99%

Complete Reduction of Lymphoedema of the Arm by Liposuction After Breast Cancer

Cited by 166 publications

References 12 publications

An Effective System of Surgical Treatment of Lymphedema

An Effective System of Surgical Treatment of Lymphedema

New developments in clinical aspects of lymphatic disease

Liposuction Gives Complete Reduction of Chronic Large Arm Lymphedema After Breast Cancer

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