The Combination of Lymph Node Transfer and Excisional Procedures in Bilateral Lower Extremity Lymphedema: Clinical Outcomes and Quality of Life Assessment with Long-Term Follow-Up.
LYMQoL questionnaire
bilateral lymphedema
liposuction
lymph node flap
lymphedema
lymphedema of the lower limbs
modified Charles procedure
primary lymphedema
quality of life
vascularized lymph node transfer
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
24 Jan 2022
24 Jan 2022
Historique:
received:
27
12
2021
revised:
17
01
2022
accepted:
21
01
2022
entrez:
15
2
2022
pubmed:
16
2
2022
medline:
16
2
2022
Statut:
epublish
Résumé
Bilateral lower extremity lymphedema is a rare and invalidating condition that poses a great challenge to the scientific community, and deeply affects the quality of life (QoL) of affected patients. A combined protocol consisting of lymph node transfer and a reductive method have never been reported for the treatment of this condition, except for small case series with brief follow-up periods. This retrospective study analyzed data of 29 patients, mean age 51 ± 17.1 years, who had been diagnosed with bilateral lower extremity lymphedema. Gastroepiploic vascularized lymph node transfer was performed in all the patients, and an excisional procedure was associated according to the clinical stage. Clinical history, circumferential limb measurements, complications, episodes of cellulitis, and responses to the Lymphedema Quality of Life Questionnaire were analyzed. The mean follow-up was 38.4 ± 11.8 months. A significant reduction in the episodes of cellulitis per year was observed ( An integrated approach is essential for the treatment of bilateral lower extremity lymphedema: reductive and reconstructive methods are complementary to achieve a successful outcome. Timely treatment and BMI reduction are relevant in order to decrease the number of episodes of cellulitis. An attentive follow-up is necessary to identify recurrence and treat affected patients in time.
Sections du résumé
BACKGROUND
BACKGROUND
Bilateral lower extremity lymphedema is a rare and invalidating condition that poses a great challenge to the scientific community, and deeply affects the quality of life (QoL) of affected patients. A combined protocol consisting of lymph node transfer and a reductive method have never been reported for the treatment of this condition, except for small case series with brief follow-up periods.
METHODS
METHODS
This retrospective study analyzed data of 29 patients, mean age 51 ± 17.1 years, who had been diagnosed with bilateral lower extremity lymphedema. Gastroepiploic vascularized lymph node transfer was performed in all the patients, and an excisional procedure was associated according to the clinical stage. Clinical history, circumferential limb measurements, complications, episodes of cellulitis, and responses to the Lymphedema Quality of Life Questionnaire were analyzed.
RESULTS
RESULTS
The mean follow-up was 38.4 ± 11.8 months. A significant reduction in the episodes of cellulitis per year was observed (
CONCLUSIONS
CONCLUSIONS
An integrated approach is essential for the treatment of bilateral lower extremity lymphedema: reductive and reconstructive methods are complementary to achieve a successful outcome. Timely treatment and BMI reduction are relevant in order to decrease the number of episodes of cellulitis. An attentive follow-up is necessary to identify recurrence and treat affected patients in time.
Identifiants
pubmed: 35160022
pii: jcm11030570
doi: 10.3390/jcm11030570
pmc: PMC8836833
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Aesthetic Plast Surg. 2020 Apr;44(2):421-432
pubmed: 31748908
Medicina (Kaunas). 2021 Jun 03;57(6):
pubmed: 34205015
Plast Reconstr Surg Glob Open. 2014 Jul 09;2(6):e167
pubmed: 25289360
J Plast Reconstr Aesthet Surg. 2021 Jan;74(1):168-173
pubmed: 32900654
Microsurgery. 2014 Sep;34(6):439-47
pubmed: 24677042
J Surg Oncol. 2018 May;117(6):1148-1156
pubmed: 29355987
Lymphat Res Biol. 2009;7(2):97-100
pubmed: 19522679
J Plast Reconstr Aesthet Surg. 2021 Mar;74(3):637-640
pubmed: 33342744
Plast Reconstr Surg Glob Open. 2018 Dec 20;6(12):e2056
pubmed: 30656125
Lymphology. 1990 Mar;23(1):23-33
pubmed: 2352440
J Plast Reconstr Aesthet Surg. 2014 Dec;67(12):1719-25
pubmed: 25153425
Eur Rev Med Pharmacol Sci. 2020 Apr;24(8):4476-4485
pubmed: 32373985
Eur Rev Med Pharmacol Sci. 2020 Aug;24(15):8028-8035
pubmed: 32767329
Lymphat Res Biol. 2018 Apr;16(2):134-139
pubmed: 29437542
Lymphology. 2016 Dec;49(4):170-84
pubmed: 29908550
Microsurgery. 2021 May;41(4):376-383
pubmed: 33864636
Plast Reconstr Surg. 2012 Apr;129(4):825-834
pubmed: 22456354
Microsurgery. 2018 Feb;38(2):222-229
pubmed: 27270748
J Plast Reconstr Aesthet Surg. 2019 Sep;72(9):1518-1524
pubmed: 31196805
Semin Plast Surg. 2018 Feb;32(1):42-47
pubmed: 29636653
J Plast Reconstr Aesthet Surg. 2019 Apr;72(4):685-710
pubmed: 30661914
Microsurgery. 2021 Jan;41(1):34-43
pubmed: 32845534
Ann Plast Surg. 2007 Aug;59(2):173-9
pubmed: 17667412
J Surg Oncol. 2020 Jan;121(1):168-174
pubmed: 31168837
Ann Plast Surg. 2011 Apr;66(4):393-402
pubmed: 21042186
J Surg Oncol. 2017 Jan;115(1):6-12
pubmed: 27353481
J Invest Surg. 2021 May 20;:1-7
pubmed: 34015977
Eur J Health Law. 2015 Sep;22(4):347-58
pubmed: 26427272
Semin Radiat Oncol. 2003 Jul;13(3):290-301
pubmed: 12903017
J Invest Surg. 2022 Mar;35(3):620-626
pubmed: 34027784
Ann Phys Rehabil Med. 2020 Jul;63(4):365-367
pubmed: 31121334
Ann Vasc Surg. 2020 May;65:284.e13-284.e18
pubmed: 31705986
Microsurgery. 2021 Sep;41(6):574-578
pubmed: 33991012
Medicina (Kaunas). 2021 Oct 28;57(11):
pubmed: 34833393
Microsurgery. 2022 Jan 7;:
pubmed: 34994481
J Surg Oncol. 2019 Mar;119(4):439-448
pubmed: 30609042
PLoS One. 2020 Feb 21;15(2):e0229138
pubmed: 32084189
Br J Dermatol. 2017 Jul;177(1):158-167
pubmed: 28000916
J Surg Oncol. 2020 Jan;121(1):175-181
pubmed: 31165487
Microsurgery. 2017 Oct;37(7):771-779
pubmed: 28334445
Lymphology. 1997 Dec;30(4):165-72
pubmed: 9476248
Medicina (Kaunas). 2021 Sep 25;57(10):
pubmed: 34684055
Lymphat Res Biol. 2018 Feb;16(1):85-91
pubmed: 28453410
J Plast Reconstr Aesthet Surg. 2017 Dec;70(12):1753-1759
pubmed: 28874308