Looking into secondary lymphedema

Gregory, Kaitlyn; Schiech, Linda

doi:10.1097/01.nurse.0000525986.49946.4e

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…Además del edema duro que no deja fóvea y el engrosamiento cutáneo deformante, se manifiesta clínicamente con pápulas y nódulos hiperqueratósicos, placas de aspecto verrugoso, fisuras, ulceración y linforrea, erisipela o celulitis a repetición, y episodios de linfangitis secundaria, que agravan el proceso de base, todo lo cual configura la denominada elefantiasis nostras verrucosa (7,8) , entidad diagnosticada en esta paciente. Ante la sospecha clínica de linfedema, se recomienda hacer una anamnesis detallada que conduzca, en lo posible, a esclarecer el agente etiológico más probable, y un examen físico completo que incluya idealmente la toma y el registro de las medidas de las circunferencias de las extremidades afectadas, siempre de forma bilateral y midiendo las mismas áreas cada vez (9) . La ultrasonografía, la tomografía computadorizada y la resonancia magnética, son estudios iniciales que permiten identificar el edema y el engrosamiento dérmico, y que ayudan a descartar causas como la insuficiencia venosa y las obstrucciones intrínsecas o extrínsecas, entre otras.…”

Section: Discussionunclassified

Elefantiasis nostras verrucosa en paciente con linfedema primario

Erazo,

Palacios

2018

rev. asoc. colomb. dermatol. cir. dematol.

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La elenfantiasis nostras verrucosa es una condición dermatológica poco frecuente, que se presenta como una complicación del linfedema crónico no filariásico, el cual raramente es de causa primaria. Por su potencial deformante y de degeneración neoplásica maligna, disminuye ostensiblemente la calidad de vida de quien la padece, por lo que es sumamente importante garantizar que estos pacientes reciban un manejo médico óptimo y oportuno para evitar la progresión del linfedema a estadios avanzados e irreversibles, como el que se presenta.

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Section: Discussionunclassified

Elefantiasis nostras verrucosa en paciente con linfedema primario

Erazo,

Palacios

2018

rev. asoc. colomb. dermatol. cir. dematol.

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“…Nursing interventions in the perioperative setting should include educating patients about the importance of recognizing the signs of complications and promptly reporting them to a health care provider, which is essential for them to receive appropriate treatment . Perioperative nurses also should be aware of the physical and psychosocial sequelae of lymphedema.…”

Section: Supermicrosurgerymentioning

confidence: 99%

“…Patients with physical extremity changes caused by lymphedema may have decreased self‐confidence and increased self‐consciousness because of a disturbance in body image and may experience negative emotions, including anxiety, frustration, sadness, and anger . Providing attentive care and education about both the physical and psychosocial implications of lymphedema, including establishing appropriate expectations for surgical outcomes, is essential to support the well‐being of individuals undergoing LVB for the management of cancer treatment–related lymphedema, which can negatively affect a patient's QOL and compromise his or her emotional well‐being …”

Section: Supermicrosurgerymentioning

confidence: 99%

Lymphedema and Lymphovenous Bypass: Perioperative Nursing Implications

Whitnell¹

2020

AORN Journal

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Lymphedema—the accumulation of fluid in tissues, usually in the upper and lower extremities—often results from lymph node dissection or radiation and can cause painful and debilitating swelling that may interfere with a patient's daily living activities and quality of life. The goal of treatment for lymphedema is to reduce the volume of fluid in the affected area. Lymphedema is staged according to presenting characteristics, and interventions may be surgical or nonsurgical, such as complex decongestive therapy. Lymphovenous bypass is a surgical procedure performed for the management of lymphedema and involves rerouting microvascular channels to allow for the drainage of fluid that has accumulated in the lymphatic tissue of the upper or lower extremities. It requires supermicrosurgery techniques because of the small size of the vessels being anastomosed. Perioperative nursing implications for lymphovenous bypass include OR preparation and providing emotional support for patients living with lymphedema.

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“…Lymphedema secondary to cancer treatment is a common and disabling complication which may arise at any time (months or years) after cancer surgery, even though it mostly occurs in the first postoperative 6–18 months (Grada & Phillips, 2017). Prevalence rates for arm lymphedema following breast cancer treatment vary from 5% to 60% in different studies and the rate of occurrence of lymphedema due to the treatment of uterine, prostate, and ovarian cancer, as well as trunk skin melanoma is 22%–80% (Gregory & Schiech, 2017). The wide variability of the rate of incidence is a result of differences between the number of cases examined, measurement methods, lack of a common definition of criteria used for the diagnosis of lymphedema, and duration of follow‐up (McLaughlin, Staley, et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Long‐term patency of multiple lymphatic‐venous anastomoses in cancer‐related lymphedema: A single center observational study

et al. 2022

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Objectives Lymphedema is always initially treated by combined decongestive physiotherapy (CDP). Those cases, refractory to CDP, may be managed by surgical therapy. One of the most used microsurgical procedures is represented by the technique of lymphatic‐venous anastomosis (LVA). But very few papers report long term results of LVA. The aim of this study is to assess the long‐term patency of multiple lymphatic‐venous anastomosis (MLVA) for the treatment of secondary lymphedemas. Methods From January 2014 to December 2014, 101 patients (mean age: 56.94 ± 8.98 years; female/male: 86/15) affected by secondary cancer‐related lymphedema (38 lower and 63 upper limbs) were treated by MLVA. All lymphedemas had previously been treated by conservative therapy without sustained results. Many patients (78%) had 1–3 episodes of acute lymphangitis/year. Lymphoscintigraphy, venous duplex‐ultrasonography, and abdominal or axillary ultrasound investigation were performed preoperatively. MLVA patency was assessed by the lymphatic transport index (LyTI) and lymphoscintigraphic pattern. Results At 1 year after surgery, excess volume reduction was 75%–90% in the early stage II secondary lymphedemas, and 60%–75% in the late stage II. The decrease in volume maintained stability in the 5‐years follow‐up period. Two more advanced lower and one upper limb lymphedemas had 45%–60% reduction. LyTI showed a significant decrease between the preoperative mean value (31.7 ± 9.43) and after 18 months from surgery (11.2 ± 1.91) (p < .001). MLVA patency was shown in 98 (97%) patients. No patients had evidence of postoperative lymphangitis. Conclusions This study demonstrated the long‐term patency of MLVA in the treatment of cancer‐related lymphedemas.

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Looking into secondary lymphedema

Cited by 3 publications

References 23 publications

Elefantiasis nostras verrucosa en paciente con linfedema primario

Elefantiasis nostras verrucosa en paciente con linfedema primario

Lymphedema and Lymphovenous Bypass: Perioperative Nursing Implications

Long‐term patency of multiple lymphatic‐venous anastomoses in cancer‐related lymphedema: A single center observational study

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