Treatment of Lymphedemas by Microsurgical Lymphatic Grafting

Baumeister, R. G. H.; Siuda, S.

doi:10.1097/00006534-199001000-00012

Cited by 205 publications

(97 citation statements)

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“…4 The alternative treatment described in the literature is lymphangioplasty 5,6 and lymphaticovenous anastomasosis. 7 This excision is also termed "the physiological approach" 8 and it is applicable to reversible states (i.e., reversible skin changes) of minor lymph stasis and easily identifiable lymphatic obstruction.…”

Section: Discussionmentioning

confidence: 99%

A surgical challenge: Idiopathic scrotal elephantiasis

Brotherhood

Metcalfe

Goldenberg

et al. 2014

CUAJ

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Scrotal elephantiasis is a condition rarely encountered in developed nations. It is endemic in tropical regions due to the presence of filariasis (Wucheria bancrofti). We report 2 cases of idiopathic scrotal elephantiasis in Canadian citizens with no history of travel to endemic filariasis regions, malignancy, surgery or radiation. Both patients underwent complete excision of the involved tissue with reconstruction. We found that for advanced cases of scrotal lymphedema, surgery is currently the only solution. In our cases of advanced idiopathic disease, surgical treatment combining the expertise of a plastic surgeon and a urologist provided a successful functional and cosmetic result.

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Section: Discussionmentioning

confidence: 99%

A surgical challenge: Idiopathic scrotal elephantiasis

Brotherhood

Metcalfe

Goldenberg

et al. 2014

CUAJ

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“…To exemplify the results of LVA, we chose objective outcome parameters for improvement of lymphtransport capacity, volume changes and quality of life. Kleinhans et al demonstrated the usefulness of the Transport Index to evaluate the results of lymphatic grafting [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature

Damstra

Voesten

Schelven

et al. 2008

Breast Cancer Res Treat

169

149

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Objective The incidence of breast cancer related lymphedema (BCRL) varies between 7-35% depending on the combination of treatment modalities. Early detection of BCRL is crucial in order to start an effective non-operative treatment program. Because of the lack of prospective research on this topic, this study was undertaken to prospectively determine the effect of Lympho Venous Anastomosis (LVA) on BCRL and to review the current literature. Study design and methods Ten patients who were previously treated for breast cancer by surgery, radiotherapy, and chemotherapy, and were unresponsive to 12-weeks of non-operative treatment, underwent an LVA procedure (Degni-Cordeiro). Objective measurements were gathered for circumferential measurement and water volumetry, and quality of life. Various types of lymphoscintigraphy were carried out pre-operatively and post-operatively at 3 and 12 months. Treatment was embedded in a multidisciplinary setting. Results Post-operative volume measurements initially showed a 4.8% reduction of lymphedema at 3 months and a 2% reduction after one year. Various scintigraphic parameters showed some improvement. Quality of life questionnaires reported minimal improvement. Reviewing the literature, only retrospective studies were found; these reported varying results for LVA procedures. The selection of patients, classification of lymphedema, indications and types of LVA, and additional therapeutic options were heterogeneous, not comparable, and lacked a validated method of effect-assessment. Conclusions Our results showed a minimal reduction in volume of lymphedema following LVA; in the literature, there was no convincing evidence of the success of LVA. Non-operative treatment and elastic stockings are still preferred by most patients with lymphedema, especially in early stages with few irreversible changes.Keywords Lympho-venous anastomosis (LVA) Á Microsurgery Á Evidence-based medicine Á Lymphoscintigraphy Á Inverse water volumetry Á Review Á Breast cancer related lymphedema

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“…For many patients with lymphedema conservative treatment does not work well or come up to their expectations, and no matter what therapy they receive, neither conservative treatment nor microsurgical procedures can remove excess adipose tissue [31][32][33][42][43][44][45]. Subcutaneous tissue debulking seems the only option to reduce the limb volume and lead to an improvement in the patient's quality of life [10].…”

Section: Why Does Liposuction Help?mentioning

confidence: 99%

Liposuction Normalizes – in Contrast to Other Therapies – Lymphedema-Induced Adipose Tissue Hypertrophy

Brorson

2013

Handchir Mikrochir plast Chir

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The various types of treatment of lymphedema are under discussion and there has been some controversy regarding liposuction for lymphedema. Although it is clear that conservative therapies such as complex decongestive therapy (CDT) and controlled compression therapy (CCT) should be tried in the first instance, options for the treatment of late-stage lymphedema that is not responding to such treatment is not so clear. Improvements in technique, patient preparation, and patient follow-up have led to a greater and a wider acceptance of liposuction as a treatment for lymphedema. This paper outlines the benefits of using liposuction and presents the evidence to support its use.

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Treatment of Lymphedemas by Microsurgical Lymphatic Grafting

Cited by 205 publications

References 0 publications

A surgical challenge: Idiopathic scrotal elephantiasis

A surgical challenge: Idiopathic scrotal elephantiasis

Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature

Liposuction Normalizes – in Contrast to Other Therapies – Lymphedema-Induced Adipose Tissue Hypertrophy

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