Free lymph node flap transfer and laser-assisted liposuction: a combined technique for the treatment of moderate upper limb lymphedema.
Identifieur interne : 001D66 ( Main/Exploration ); précédent : 001D65; suivant : 001D67Free lymph node flap transfer and laser-assisted liposuction: a combined technique for the treatment of moderate upper limb lymphedema.
Auteurs : Fabio Nicoli [Taïwan] ; Joannis Constantinides ; Pedro Ciudad ; Stamatis Sapountzis ; Kidakorn Kiranantawat ; Davide Lazzeri ; Seong Yoon Lim ; Marzia Nicoli ; Pei-Yu Chen ; Matthew Sze-Wei Yeo ; Ram M. Chilgar ; Hung-Chi ChenSource :
- Lasers in medical science [ 1435-604X ] ; 2015.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Bras, Tumeurs du sein.
- Adulte d'âge moyen, Bras, Femelle, Humains, Lipectomie, Lymphoedème, Mastectomie, Microchirurgie, Noeuds lymphatiques, Résultat thérapeutique, Sujet âgé, Tumeurs du sein.
English descriptors
- KwdEn :
- MESH :
- methods : Lipectomy, Microsurgery.
- pathology : Arm, Breast Neoplasms.
- surgery : Arm, Breast Neoplasms, Lymph Nodes, Lymphedema.
- transplantation : Lymph Nodes.
- Aged, Female, Humans, Mastectomy, Middle Aged, Treatment Outcome.
Abstract
Upper limb lymphedema following breast cancer surgery is a challenging problem for the surgeon. Lymphatico-venous or lymphatico-lymphatic anastomoses have been used to restore the continuity of the lymphatic system, offering a degree of improvement. Long-term review indicates that lumen obliteration and occlusion at the anastomosis level commonly occurs with time as a result of elevated venous pressure. Lymph node flap transfer is another microsurgical procedure designed to restore lymphatic system physiology but does not provide a complete volume reduction, particularly in the presence of hypertrophied adipose tissue and fibrosis, common in moderate and advanced lymphedema. Laser-assisted liposuction has been shown to effectively reduce fat and fibrotic tissues. We present preliminary results of our practice using a combination of lymph node flap transfer and laser-assisted liposuction. Between October 2012 and May 2013, ten patients (mean 54.6 ± 9.3 years) with moderate (stage II) upper extremity lymphedema underwent groin or supraclavicular lymph node flap transfer combined with laser-assisted liposuction (high-power diode pulsed laser with 1470-nm wavelength, LASEmaR 1500-EUFOTON, Trieste, Italy). A significant decrease of upper limb circumference measurements at all levels was noted postoperatively. Skin tonicity was improved in all patients. Postoperative lymphoscintigraphy revealed reduced lymph stasis. No patient suffered from donor site morbidity. Our results suggest that combining laser liposuction with lymph node flap transfer is a safe and reliable procedure, achieving a reduction of upper limb volume in treated patients suffering from moderate upper extremity lymphedema.
DOI: 10.1007/s10103-015-1736-3
PubMed: 25820369
Affiliations:
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Chilgar</name></author><author><name sortKey="Chen, Hung Chi" sort="Chen, Hung Chi" uniqKey="Chen H" first="Hung-Chi" last="Chen">Hung-Chi Chen</name></author></analytic><series><title level="j">Lasers in medical science</title><idno type="eISSN">1435-604X</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Arm (pathology)</term><term>Arm (surgery)</term><term>Breast Neoplasms (pathology)</term><term>Breast Neoplasms (surgery)</term><term>Female</term><term>Humans</term><term>Lipectomy (methods)</term><term>Lymph Nodes (surgery)</term><term>Lymph Nodes (transplantation)</term><term>Lymphedema (surgery)</term><term>Mastectomy</term><term>Microsurgery (methods)</term><term>Middle Aged</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Bras ()</term><term>Bras (anatomopathologie)</term><term>Femelle</term><term>Humains</term><term>Lipectomie ()</term><term>Lymphoedème ()</term><term>Mastectomie</term><term>Microchirurgie ()</term><term>Noeuds lymphatiques ()</term><term>Noeuds lymphatiques (transplantation)</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Tumeurs du sein ()</term><term>Tumeurs du sein (anatomopathologie)</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Bras</term><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lipectomy</term><term>Microsurgery</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Arm</term><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Arm</term><term>Breast Neoplasms</term><term>Lymph Nodes</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="transplantation" xml:lang="en"><term>Lymph Nodes</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Mastectomy</term><term>Middle Aged</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Bras</term><term>Femelle</term><term>Humains</term><term>Lipectomie</term><term>Lymphoedème</term><term>Mastectomie</term><term>Microchirurgie</term><term>Noeuds lymphatiques</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Tumeurs du sein</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Upper limb lymphedema following breast cancer surgery is a challenging problem for the surgeon. Lymphatico-venous or lymphatico-lymphatic anastomoses have been used to restore the continuity of the lymphatic system, offering a degree of improvement. Long-term review indicates that lumen obliteration and occlusion at the anastomosis level commonly occurs with time as a result of elevated venous pressure. Lymph node flap transfer is another microsurgical procedure designed to restore lymphatic system physiology but does not provide a complete volume reduction, particularly in the presence of hypertrophied adipose tissue and fibrosis, common in moderate and advanced lymphedema. Laser-assisted liposuction has been shown to effectively reduce fat and fibrotic tissues. We present preliminary results of our practice using a combination of lymph node flap transfer and laser-assisted liposuction. Between October 2012 and May 2013, ten patients (mean 54.6 ± 9.3 years) with moderate (stage II) upper extremity lymphedema underwent groin or supraclavicular lymph node flap transfer combined with laser-assisted liposuction (high-power diode pulsed laser with 1470-nm wavelength, LASEmaR 1500-EUFOTON, Trieste, Italy). A significant decrease of upper limb circumference measurements at all levels was noted postoperatively. Skin tonicity was improved in all patients. Postoperative lymphoscintigraphy revealed reduced lymph stasis. No patient suffered from donor site morbidity. Our results suggest that combining laser liposuction with lymph node flap transfer is a safe and reliable procedure, achieving a reduction of upper limb volume in treated patients suffering from moderate upper extremity lymphedema.</div></front></TEI><affiliations><list><country><li>Taïwan</li></country></list><tree><noCountry><name sortKey="Chen, Hung Chi" sort="Chen, Hung Chi" uniqKey="Chen H" first="Hung-Chi" last="Chen">Hung-Chi Chen</name><name sortKey="Chen, Pei Yu" sort="Chen, Pei Yu" uniqKey="Chen P" first="Pei-Yu" last="Chen">Pei-Yu Chen</name><name sortKey="Chilgar, Ram M" sort="Chilgar, Ram M" uniqKey="Chilgar R" first="Ram M" last="Chilgar">Ram M. Chilgar</name><name sortKey="Ciudad, Pedro" sort="Ciudad, Pedro" uniqKey="Ciudad P" first="Pedro" last="Ciudad">Pedro Ciudad</name><name sortKey="Constantinides, Joannis" sort="Constantinides, Joannis" uniqKey="Constantinides J" first="Joannis" last="Constantinides">Joannis Constantinides</name><name sortKey="Kiranantawat, Kidakorn" sort="Kiranantawat, Kidakorn" uniqKey="Kiranantawat K" first="Kidakorn" last="Kiranantawat">Kidakorn Kiranantawat</name><name sortKey="Lazzeri, Davide" sort="Lazzeri, Davide" uniqKey="Lazzeri D" first="Davide" last="Lazzeri">Davide Lazzeri</name><name sortKey="Lim, Seong Yoon" sort="Lim, Seong Yoon" uniqKey="Lim S" first="Seong Yoon" last="Lim">Seong Yoon Lim</name><name sortKey="Nicoli, Marzia" sort="Nicoli, Marzia" uniqKey="Nicoli M" first="Marzia" last="Nicoli">Marzia Nicoli</name><name sortKey="Sapountzis, Stamatis" sort="Sapountzis, Stamatis" uniqKey="Sapountzis S" first="Stamatis" last="Sapountzis">Stamatis Sapountzis</name><name sortKey="Yeo, Matthew Sze Wei" sort="Yeo, Matthew Sze Wei" uniqKey="Yeo M" first="Matthew Sze-Wei" last="Yeo">Matthew Sze-Wei Yeo</name></noCountry><country name="Taïwan"><noRegion><name sortKey="Nicoli, Fabio" sort="Nicoli, Fabio" uniqKey="Nicoli F" first="Fabio" last="Nicoli">Fabio Nicoli</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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