Lymphatic microsurgery to treat lymphedema: techniques and indications for better results.
Identifieur interne : 003463 ( Main/Exploration ); précédent : 003462; suivant : 003464Lymphatic microsurgery to treat lymphedema: techniques and indications for better results.
Auteurs : Francesco Boccardo [Italie] ; Ezio Fulcheri ; Giuseppe Villa ; Lidia Molinari ; Corrado Campisi ; Sara Dessalvi ; Giuseppe Murdaca ; Caterina Campisi ; Pier Luigi Santi ; Aurora Parodi ; Francesco Puppo ; Corradino CampisiSource :
- Annals of plastic surgery [ 1536-3708 ] ; 2013.
Descripteurs français
- KwdFr :
- Anastomose chirurgicale, Greffe vasculaire (), Humains, Lymphoedème (), Lymphoedème (anatomopathologie), Lymphoedème (imagerie diagnostique), Microchirurgie (), Résultat thérapeutique, Scintigraphie, Vaisseaux lymphatiques (), Vaisseaux lymphatiques (anatomopathologie), Vaisseaux lymphatiques (imagerie diagnostique), Veines (), Études de suivi.
- MESH :
- anatomopathologie : Lymphoedème, Vaisseaux lymphatiques.
- imagerie diagnostique : Lymphoedème, Vaisseaux lymphatiques.
- Anastomose chirurgicale, Greffe vasculaire, Humains, Lymphoedème, Microchirurgie, Résultat thérapeutique, Scintigraphie, Vaisseaux lymphatiques, Veines, Études de suivi.
English descriptors
- KwdEn :
- Anastomosis, Surgical, Follow-Up Studies, Humans, Lymphatic Vessels (diagnostic imaging), Lymphatic Vessels (pathology), Lymphatic Vessels (surgery), Lymphedema (diagnostic imaging), Lymphedema (pathology), Lymphedema (surgery), Microsurgery (methods), Radionuclide Imaging, Treatment Outcome, Vascular Grafting (methods), Veins (surgery).
- MESH :
- diagnostic imaging : Lymphatic Vessels, Lymphedema.
- methods : Microsurgery, Vascular Grafting.
- pathology : Lymphatic Vessels, Lymphedema.
- surgery : Lymphatic Vessels, Lymphedema, Veins.
- Anastomosis, Surgical, Follow-Up Studies, Humans, Radionuclide Imaging, Treatment Outcome.
Abstract
This study aimed to report new clinical approaches to the treatment of lymphatic disorders by microsurgical techniques based on histological and immunohistochemical findings. The authors' wide clinical experience in the treatment of patients with peripheral lymphedema by microsurgical techniques is reported. Microsurgical methods included derivative lymphatic-venous anastomoses and lymphatic reconstruction by interpositioned vein grafted shunts. In all patients, lymphatic and lymph nodal tissues were sent for histological assessment, together with specimen of the interstitial matrix. Diagnostic investigations consisted in venous duplex scan and lymphoscintigraphy. Results were assessed clinically by volumetry performed preoperatively and postoperatively at 3 to 6 months and at 1, 3, and 5 years. The outcome obtained in treating lymphedemas at different stages was analyzed for volume reduction, stability of results with time, reduction of dermatolymphangioadenitis attacks, necessity of wearing elastic supports, and use of conservative measures postoperatively. Microsurgical lymphatic derivative and reconstructive techniques allow bringing about positive results in the treatment of peripheral lymphedema, above all in early stages when tissular changes are slight and allow almost a complete restore of lymphatic drainage.
DOI: 10.1097/SAP.0b013e31824f20d4
PubMed: 23542829
Affiliations:
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Martino University Hospital-IST, Genoa, Italy. Francesco.boccardo@unige.it</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Unit of Lymphatic Surgery, Department of Surgery, IRCCS S. Martino University Hospital-IST, Genoa</wicri:regionArea><wicri:noRegion>Genoa</wicri:noRegion></affiliation></author><author><name sortKey="Fulcheri, Ezio" sort="Fulcheri, Ezio" uniqKey="Fulcheri E" first="Ezio" last="Fulcheri">Ezio Fulcheri</name></author><author><name sortKey="Villa, Giuseppe" sort="Villa, Giuseppe" uniqKey="Villa G" first="Giuseppe" last="Villa">Giuseppe Villa</name></author><author><name sortKey="Molinari, Lidia" sort="Molinari, Lidia" uniqKey="Molinari L" first="Lidia" last="Molinari">Lidia Molinari</name></author><author><name sortKey="Campisi, Corrado" sort="Campisi, Corrado" uniqKey="Campisi C" first="Corrado" last="Campisi">Corrado Campisi</name></author><author><name sortKey="Dessalvi, Sara" sort="Dessalvi, Sara" uniqKey="Dessalvi S" first="Sara" last="Dessalvi">Sara Dessalvi</name></author><author><name sortKey="Murdaca, Giuseppe" sort="Murdaca, Giuseppe" uniqKey="Murdaca G" first="Giuseppe" last="Murdaca">Giuseppe Murdaca</name></author><author><name sortKey="Campisi, Caterina" sort="Campisi, Caterina" uniqKey="Campisi C" first="Caterina" last="Campisi">Caterina Campisi</name></author><author><name sortKey="Santi, Pier Luigi" sort="Santi, Pier Luigi" uniqKey="Santi P" first="Pier Luigi" last="Santi">Pier Luigi Santi</name></author><author><name sortKey="Parodi, Aurora" sort="Parodi, Aurora" uniqKey="Parodi A" first="Aurora" last="Parodi">Aurora Parodi</name></author><author><name sortKey="Puppo, Francesco" sort="Puppo, Francesco" uniqKey="Puppo F" first="Francesco" last="Puppo">Francesco Puppo</name></author><author><name sortKey="Campisi, Corradino" sort="Campisi, Corradino" uniqKey="Campisi C" first="Corradino" last="Campisi">Corradino Campisi</name></author></analytic><series><title level="j">Annals of plastic surgery</title><idno type="eISSN">1536-3708</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anastomosis, Surgical</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymphatic Vessels (diagnostic imaging)</term><term>Lymphatic Vessels (pathology)</term><term>Lymphatic Vessels (surgery)</term><term>Lymphedema (diagnostic imaging)</term><term>Lymphedema (pathology)</term><term>Lymphedema (surgery)</term><term>Microsurgery (methods)</term><term>Radionuclide Imaging</term><term>Treatment Outcome</term><term>Vascular Grafting (methods)</term><term>Veins (surgery)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Anastomose chirurgicale</term><term>Greffe vasculaire ()</term><term>Humains</term><term>Lymphoedème ()</term><term>Lymphoedème (anatomopathologie)</term><term>Lymphoedème (imagerie diagnostique)</term><term>Microchirurgie ()</term><term>Résultat thérapeutique</term><term>Scintigraphie</term><term>Vaisseaux lymphatiques ()</term><term>Vaisseaux lymphatiques (anatomopathologie)</term><term>Vaisseaux lymphatiques (imagerie diagnostique)</term><term>Veines ()</term><term>Études de suivi</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Lymphoedème</term><term>Vaisseaux lymphatiques</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Lymphatic Vessels</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Lymphoedème</term><term>Vaisseaux lymphatiques</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Microsurgery</term><term>Vascular Grafting</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Lymphatic Vessels</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Lymphatic Vessels</term><term>Lymphedema</term><term>Veins</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Anastomosis, Surgical</term><term>Follow-Up Studies</term><term>Humans</term><term>Radionuclide Imaging</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Anastomose chirurgicale</term><term>Greffe vasculaire</term><term>Humains</term><term>Lymphoedème</term><term>Microchirurgie</term><term>Résultat thérapeutique</term><term>Scintigraphie</term><term>Vaisseaux lymphatiques</term><term>Veines</term><term>Études de suivi</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">This study aimed to report new clinical approaches to the treatment of lymphatic disorders by microsurgical techniques based on histological and immunohistochemical findings. The authors' wide clinical experience in the treatment of patients with peripheral lymphedema by microsurgical techniques is reported. Microsurgical methods included derivative lymphatic-venous anastomoses and lymphatic reconstruction by interpositioned vein grafted shunts. In all patients, lymphatic and lymph nodal tissues were sent for histological assessment, together with specimen of the interstitial matrix. Diagnostic investigations consisted in venous duplex scan and lymphoscintigraphy. Results were assessed clinically by volumetry performed preoperatively and postoperatively at 3 to 6 months and at 1, 3, and 5 years. The outcome obtained in treating lymphedemas at different stages was analyzed for volume reduction, stability of results with time, reduction of dermatolymphangioadenitis attacks, necessity of wearing elastic supports, and use of conservative measures postoperatively. Microsurgical lymphatic derivative and reconstructive techniques allow bringing about positive results in the treatment of peripheral lymphedema, above all in early stages when tissular changes are slight and allow almost a complete restore of lymphatic drainage.</div></front></TEI><affiliations><list><country><li>Italie</li></country></list><tree><noCountry><name sortKey="Campisi, Caterina" sort="Campisi, Caterina" uniqKey="Campisi C" first="Caterina" last="Campisi">Caterina Campisi</name><name sortKey="Campisi, Corradino" sort="Campisi, Corradino" uniqKey="Campisi C" first="Corradino" last="Campisi">Corradino Campisi</name><name sortKey="Campisi, Corrado" sort="Campisi, Corrado" uniqKey="Campisi C" first="Corrado" last="Campisi">Corrado Campisi</name><name sortKey="Dessalvi, Sara" sort="Dessalvi, Sara" uniqKey="Dessalvi S" first="Sara" last="Dessalvi">Sara Dessalvi</name><name sortKey="Fulcheri, Ezio" sort="Fulcheri, Ezio" uniqKey="Fulcheri E" first="Ezio" last="Fulcheri">Ezio Fulcheri</name><name sortKey="Molinari, Lidia" sort="Molinari, Lidia" uniqKey="Molinari L" first="Lidia" last="Molinari">Lidia Molinari</name><name sortKey="Murdaca, Giuseppe" sort="Murdaca, Giuseppe" uniqKey="Murdaca G" first="Giuseppe" last="Murdaca">Giuseppe Murdaca</name><name sortKey="Parodi, Aurora" sort="Parodi, Aurora" uniqKey="Parodi A" first="Aurora" last="Parodi">Aurora Parodi</name><name sortKey="Puppo, Francesco" sort="Puppo, Francesco" uniqKey="Puppo F" first="Francesco" last="Puppo">Francesco Puppo</name><name sortKey="Santi, Pier Luigi" sort="Santi, Pier Luigi" uniqKey="Santi P" first="Pier Luigi" last="Santi">Pier Luigi Santi</name><name sortKey="Villa, Giuseppe" sort="Villa, Giuseppe" uniqKey="Villa G" first="Giuseppe" last="Villa">Giuseppe Villa</name></noCountry><country name="Italie"><noRegion><name sortKey="Boccardo, Francesco" sort="Boccardo, Francesco" uniqKey="Boccardo F" first="Francesco" last="Boccardo">Francesco Boccardo</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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