Debulking Surgery for Elephantiasis Nostras With Large Ectatic Podoplanin-Negative Lymphatic Vessels in Patients With Lipo-Lymphedema
Identifieur interne : 002B91 ( Main/Exploration ); précédent : 002B90; suivant : 002B92Debulking Surgery for Elephantiasis Nostras With Large Ectatic Podoplanin-Negative Lymphatic Vessels in Patients With Lipo-Lymphedema
Auteurs : Uwe Wollina [Allemagne] ; Birgit Heinig [Allemagne] ; Jaqueline Schönlebe [Allemagne] ; Andreas Nowak [Allemagne]Source :
- Eplasty [ 1937-5719 ] ; 2014.
Abstract
Url:
PubMed: 24741382
PubMed Central: 3944717
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Debulking Surgery for Elephantiasis Nostras With Large Ectatic Podoplanin-Negative Lymphatic Vessels in Patients With Lipo-Lymphedema</title><author><name sortKey="Wollina, Uwe" sort="Wollina, Uwe" uniqKey="Wollina U" first="Uwe" last="Wollina">Uwe Wollina</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Heinig, Birgit" sort="Heinig, Birgit" uniqKey="Heinig B" first="Birgit" last="Heinig">Birgit Heinig</name><affiliation wicri:level="3"><nlm:aff id="aff2">Department of Physical Therapy and Rehabilitative Medicine, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Physical Therapy and Rehabilitative Medicine, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Schonlebe, Jaqueline" sort="Schonlebe, Jaqueline" uniqKey="Schonlebe J" first="Jaqueline" last="Schönlebe">Jaqueline Schönlebe</name><affiliation wicri:level="3"><nlm:aff id="aff3">Institute of Pathology “Georg Schmorl”, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Pathology 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Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Heinig, Birgit" sort="Heinig, Birgit" uniqKey="Heinig B" first="Birgit" last="Heinig">Birgit Heinig</name><affiliation wicri:level="3"><nlm:aff id="aff2">Department of Physical Therapy and Rehabilitative Medicine, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Physical Therapy and Rehabilitative Medicine, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Schonlebe, Jaqueline" sort="Schonlebe, Jaqueline" uniqKey="Schonlebe J" first="Jaqueline" last="Schönlebe">Jaqueline Schönlebe</name><affiliation wicri:level="3"><nlm:aff id="aff3">Institute of Pathology “Georg Schmorl”, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Pathology “Georg Schmorl”, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Nowak, Andreas" sort="Nowak, Andreas" uniqKey="Nowak A" first="Andreas" last="Nowak">Andreas Nowak</name><affiliation wicri:level="3"><nlm:aff id="aff4">Department of Anesthesiology and Intensive Medical Care, Emergency Medicine and Pain Management, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Anesthesiology and Intensive Medical Care, Emergency Medicine and Pain Management, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author></analytic><series><title level="j">Eplasty</title><idno type="eISSN">1937-5719</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Objective:</bold> Elephantiasis nostras is a rare complication in advanced lipo-lymphedema. While lipedema can be treated by liposuction and lymphedema by decongestive lymphatic therapy, elephantiasis nostras may need debulking surgery. <bold>Methods:</bold> We present 2 cases of advanced lipo-lymphedema complicated by elephantiasis nostras. After tumescent microcannular laser-assisted liposuction both patients underwent a debulking surgery with a modification of Auchincloss-Kim's technique. Histologic examination of the tissue specimen was performed. <bold>Results:</bold> The surgical treatment was well tolerated and primary healing was uneventful. After primary wound healing and ambulation of the patients, a delayed ulceration with lymphorrhea developed. It was treated by surgical necrectomy and vacuum-assisted closure leading to complete healing. Mobility of the leg was much improved. Histologic examination revealed massive ectatic lymphatic vessels nonreactive for podoplanin. <bold>Conclusions:</bold> Debulking surgery can be an adjuvant technique for elephantiasis nostras in advanced lipo-lymphedema. Although delayed postoperative wound healing problems were observed, necrectomy and vacuum-assisted closure achieved a complete healing. Histologic data suggest that the ectatic lymphatic vessels in these patients resemble finding in podoplanin knockout mice. The findings would explain the limitations of decongestive lymphatic therapy and tumescent liposuction in such patients and their predisposition to relapsing erysipelas.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Kasseroller, Rg" uniqKey="Kasseroller R">RG Kasseroller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Foldi, E" uniqKey="Foldi E">E Földi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stout, N" uniqKey="Stout N">N Stout</name></author><author><name sortKey="Partsch, H" uniqKey="Partsch H">H Partsch</name></author><author><name sortKey="Szolnoky, G" uniqKey="Szolnoky G">G Szolnoky</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lee, Bb" uniqKey="Lee B">BB Lee</name></author><author><name sortKey="Kim, Yw" uniqKey="Kim Y">YW Kim</name></author><author><name sortKey="Kim, Di" 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uniqKey="Wollina U">U Wollina</name></author><author><name sortKey="Hansel, G" uniqKey="Hansel G">G Hansel</name></author><author><name sortKey="Kronert, C" uniqKey="Kronert C">C Krönert</name></author><author><name sortKey="Heinig, B" uniqKey="Heinig B">B Heinig</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tauber, R" uniqKey="Tauber R">R Tauber</name></author><author><name sortKey="Schmid, S" uniqKey="Schmid S">S Schmid</name></author><author><name sortKey="Horn, T" uniqKey="Horn T">T Horn</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>District de Dresde</li><li>Saxe (Land)</li></region><settlement><li>Dresde</li></settlement></list><tree><country name="Allemagne"><region name="Saxe (Land)"><name sortKey="Wollina, Uwe" sort="Wollina, Uwe" uniqKey="Wollina U" first="Uwe" last="Wollina">Uwe Wollina</name></region><name sortKey="Heinig, Birgit" sort="Heinig, Birgit" uniqKey="Heinig B" first="Birgit" last="Heinig">Birgit Heinig</name><name sortKey="Nowak, Andreas" sort="Nowak, Andreas" uniqKey="Nowak A" first="Andreas" last="Nowak">Andreas Nowak</name><name sortKey="Schonlebe, Jaqueline" sort="Schonlebe, Jaqueline" uniqKey="Schonlebe J" first="Jaqueline" last="Schönlebe">Jaqueline Schönlebe</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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