The relationship between lymphedema severity and awareness of lymphedema surgery

Abstract

Background During the early stages of lymphedema, active physiologic surgical treatment can be applied. However, lymphedema patients often have limited knowledge and misconceptions regarding lymphedema and surgical treatment. We analyzed the correlations between lymphedema severity and surgical technique according to patients’ awareness of surgical treatment for secondary upper extremity lymphedema (UEL).Methods Patients with UEL diagnosed between December 2017 and December 2019 were retrospectively evaluated. At the time of their presentation to our hospital for the treatment of lymphedema, they were administered a questionnaire about lymphedema and lymphedema surgery. Based on the results, patients were classified as being aware or unaware of surgical treatment. Lymphedema severity was classified according to the arm dermal backflow (ADB) stage and the MD Anderson Cancer Center (MDACC) stage based on indocyanine green lymphography conducted at presentation. Surgical techniques were compared between the two groups.Results Patients who were aware of surgical treatment had significantly lower initial ADB and MDACC stages (P<0.05) and more frequently underwent physiologic procedures than excisional procedures (P=0.003).Conclusions If patients are actively educated regarding surgical treatment of lymphedema, physiologic procedures may be performed during the early stages of UEL.

The Quality of Life after Lymphaticovenous Anastomosis in 118 Lower Limb Lymphedema Patients

“…However, studies have shown conflicting reports in regard to the correlation between QOL and volume reduction. 29 30 31 32 Further evaluation will be needed to ultimately determine how volume reduction will play a role in improving the overall QOL. This study suggests that significant improvements are made in the QOL of patients after LVA based on multiple factors not only limited to but including the amount of lower limb volume reduction.…”

Outcomes of lipectomy in patients with advanced unilateral upper extremity lymphedema with regard to the difference in time required for indocyanine green to reach the axilla: A retrospective cohort study in a single center

“…[ 7 ] However, due to the lack of both awareness of the disease and experts in this field, several patients do not receive adequate treatment and visit the hospital when the disease has reached an advanced stage. [ 8 , 9 ]…”

“…[7] However, due to the lack of both awareness of the disease and experts in this field, several patients do not receive adequate treatment and visit the hospital when the disease has reached an advanced stage. [8,9] The goal of surgical treatment for lymphedema is to reduce the accumulated fluid or fat or induce lymphatic drainage through an alternative pathway. [1] Lymphaticovenous anastomosis (LVA) or vascularized lymph node transfer (VLNT) aims to induce physiological lymphatic drainage.…”