[Update on special surgical approaches in the therapy for lymphedemas].
Identifieur interne : 003C93 ( Main/Exploration ); précédent : 003C92; suivant : 003C94[Update on special surgical approaches in the therapy for lymphedemas].
Auteurs : J. Wallmichrath [Allemagne] ; R. Baumeister ; R E Giunta ; M. Notohamiprodjo ; A. FrickSource :
- Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V... [ 1439-3980 ] ; 2012.
Descripteurs français
- KwdFr :
- Anastomose chirurgicale (), Bandages de compression, Drainage (), Humains, Lambeaux chirurgicaux, Lipectomie (), Lymphe (physiologie), Lymphoedème (), Lymphoedème (diagnostic), Lymphoedème (physiopathologie), Membres (), Microchirurgie (), Procédures de chirurgie reconstructive (), Tissu lymphoïde (), Tissu lymphoïde (physiopathologie), Vaisseaux lymphatiques (), Veines (transplantation).
- MESH :
- diagnostic : Lymphoedème.
- physiologie : Lymphe.
- physiopathologie : Lymphoedème, Tissu lymphoïde.
- Anastomose chirurgicale, Bandages de compression, Drainage, Humains, Lambeaux chirurgicaux, Lipectomie, Lymphoedème, Membres, Microchirurgie, Procédures de chirurgie reconstructive, Tissu lymphoïde, Vaisseaux lymphatiques, Veines.
English descriptors
- KwdEn :
- Anastomosis, Surgical (methods), Compression Bandages, Drainage (methods), Extremities (surgery), Humans, Lipectomy (methods), Lymph (physiology), Lymphatic Vessels (surgery), Lymphedema (classification), Lymphedema (diagnosis), Lymphedema (physiopathology), Lymphedema (surgery), Lymphoid Tissue (physiopathology), Lymphoid Tissue (surgery), Microsurgery (methods), Reconstructive Surgical Procedures (methods), Surgical Flaps, Veins (transplantation).
- MESH :
- classification : Lymphedema.
- diagnosis : Lymphedema.
- methods : Anastomosis, Surgical, Drainage, Lipectomy, Microsurgery, Reconstructive Surgical Procedures.
- physiology : Lymph.
- physiopathology : Lymphedema, Lymphoid Tissue.
- surgery : Extremities, Lymphatic Vessels, Lymphedema, Lymphoid Tissue.
- transplantation : Veins.
- Compression Bandages, Humans, Surgical Flaps.
Abstract
Despite recent medical progress primary and secondary lymphedemas still represent a therapeutic challenge and they often lead to a significant reduction in quality of life. Lymphedemas usually develop in the extremities, the male external genitals as well as the female breast as a consequence to the axial alignment of the lymphatic collectors. Early stages are characterized by an excess of lymph fluid increasing the volume of the affected part of the body whereas later stages represent an increasing amount of solid tissue. Thus therapeutic efforts can focus on the reduction of the surplus of liquid and/or solid components. Generally there are conservative and operative strategies. Conservative measures mainly focus on the improvement of fluid mobilization and drainage and comprise compression garments, manual lymphatic drainage, and apparative intermittent compression. Operative approaches comprise procedures for surgical tissue reduction (symptomatic/ablative approaches) and/or procedures with the intention of enhancing lymphatic transport (causal approaches). Surgical tissue reduction can be performed by open resection and/or liposuction. Traditional surgical causal techniques such as transposition of local flaps aim at leading lymph away from the congested region of the body. Modern microsurgical causal approaches contain methods of reconstruction of interrupted lymphatic pathways as well as techniques for the conduction of lymph into local veins. In this review we depict and discuss the features of the multiform spectrum of the surgical therapy of lymphedemas on the basis of literature as well as our own clinical and experimental experience.
DOI: 10.1055/s-0032-1323840
PubMed: 23093446
Affiliations:
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Wallmichrath</name><affiliation wicri:level="1"><nlm:affiliation>Handchirurgie, Plastische Chirurgie, Äshetische Chirurgie, Klinikum der Ludwig-Maximilians Universität, Marchioninistraße 15, 81377 München. jens.wallmichrath@med.uni-muenchen.de</nlm:affiliation><country>Allemagne</country><placeName><settlement type="city">Munich</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region></placeName><wicri:regionArea>Handchirurgie, Plastische Chirurgie, Äshetische Chirurgie, Klinikum der Ludwig-Maximilians Universität, Marchioninistraße 15</wicri:regionArea><wicri:noRegion>Marchioninistraße 15</wicri:noRegion><wicri:noRegion>Marchioninistraße 15</wicri:noRegion><wicri:noRegion>Marchioninistraße 15</wicri:noRegion></affiliation></author><author><name sortKey="Baumeister, R" sort="Baumeister, R" uniqKey="Baumeister R" first="R" last="Baumeister">R. Baumeister</name></author><author><name sortKey="Giunta, R E" sort="Giunta, R E" uniqKey="Giunta R" first="R E" last="Giunta">R E Giunta</name></author><author><name sortKey="Notohamiprodjo, M" sort="Notohamiprodjo, M" uniqKey="Notohamiprodjo M" first="M" last="Notohamiprodjo">M. Notohamiprodjo</name></author><author><name sortKey="Frick, A" sort="Frick, A" uniqKey="Frick A" first="A" last="Frick">A. Frick</name></author></analytic><series><title level="j">Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...</title><idno type="eISSN">1439-3980</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anastomosis, Surgical (methods)</term><term>Compression Bandages</term><term>Drainage (methods)</term><term>Extremities (surgery)</term><term>Humans</term><term>Lipectomy (methods)</term><term>Lymph (physiology)</term><term>Lymphatic Vessels (surgery)</term><term>Lymphedema (classification)</term><term>Lymphedema (diagnosis)</term><term>Lymphedema (physiopathology)</term><term>Lymphedema (surgery)</term><term>Lymphoid Tissue (physiopathology)</term><term>Lymphoid Tissue (surgery)</term><term>Microsurgery (methods)</term><term>Reconstructive Surgical Procedures (methods)</term><term>Surgical Flaps</term><term>Veins (transplantation)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Anastomose chirurgicale ()</term><term>Bandages de compression</term><term>Drainage ()</term><term>Humains</term><term>Lambeaux chirurgicaux</term><term>Lipectomie ()</term><term>Lymphe (physiologie)</term><term>Lymphoedème ()</term><term>Lymphoedème (diagnostic)</term><term>Lymphoedème (physiopathologie)</term><term>Membres ()</term><term>Microchirurgie ()</term><term>Procédures de chirurgie reconstructive ()</term><term>Tissu lymphoïde ()</term><term>Tissu lymphoïde (physiopathologie)</term><term>Vaisseaux lymphatiques ()</term><term>Veines (transplantation)</term></keywords><keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Anastomosis, Surgical</term><term>Drainage</term><term>Lipectomy</term><term>Microsurgery</term><term>Reconstructive Surgical Procedures</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Lymphe</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Lymph</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Lymphoedème</term><term>Tissu lymphoïde</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Lymphedema</term><term>Lymphoid Tissue</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Extremities</term><term>Lymphatic Vessels</term><term>Lymphedema</term><term>Lymphoid Tissue</term></keywords><keywords scheme="MESH" qualifier="transplantation" xml:lang="en"><term>Veins</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Compression Bandages</term><term>Humans</term><term>Surgical Flaps</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Anastomose chirurgicale</term><term>Bandages de compression</term><term>Drainage</term><term>Humains</term><term>Lambeaux chirurgicaux</term><term>Lipectomie</term><term>Lymphoedème</term><term>Membres</term><term>Microchirurgie</term><term>Procédures de chirurgie reconstructive</term><term>Tissu lymphoïde</term><term>Vaisseaux lymphatiques</term><term>Veines</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Despite recent medical progress primary and secondary lymphedemas still represent a therapeutic challenge and they often lead to a significant reduction in quality of life. Lymphedemas usually develop in the extremities, the male external genitals as well as the female breast as a consequence to the axial alignment of the lymphatic collectors. Early stages are characterized by an excess of lymph fluid increasing the volume of the affected part of the body whereas later stages represent an increasing amount of solid tissue. Thus therapeutic efforts can focus on the reduction of the surplus of liquid and/or solid components. Generally there are conservative and operative strategies. Conservative measures mainly focus on the improvement of fluid mobilization and drainage and comprise compression garments, manual lymphatic drainage, and apparative intermittent compression. Operative approaches comprise procedures for surgical tissue reduction (symptomatic/ablative approaches) and/or procedures with the intention of enhancing lymphatic transport (causal approaches). Surgical tissue reduction can be performed by open resection and/or liposuction. Traditional surgical causal techniques such as transposition of local flaps aim at leading lymph away from the congested region of the body. Modern microsurgical causal approaches contain methods of reconstruction of interrupted lymphatic pathways as well as techniques for the conduction of lymph into local veins. In this review we depict and discuss the features of the multiform spectrum of the surgical therapy of lymphedemas on the basis of literature as well as our own clinical and experimental experience.</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Bavière</li><li>District de Haute-Bavière</li></region><settlement><li>Munich</li></settlement></list><tree><noCountry><name sortKey="Baumeister, R" sort="Baumeister, R" uniqKey="Baumeister R" first="R" last="Baumeister">R. Baumeister</name><name sortKey="Frick, A" sort="Frick, A" uniqKey="Frick A" first="A" last="Frick">A. Frick</name><name sortKey="Giunta, R E" sort="Giunta, R E" uniqKey="Giunta R" first="R E" last="Giunta">R E Giunta</name><name sortKey="Notohamiprodjo, M" sort="Notohamiprodjo, M" uniqKey="Notohamiprodjo M" first="M" last="Notohamiprodjo">M. Notohamiprodjo</name></noCountry><country name="Allemagne"><region name="Bavière"><name sortKey="Wallmichrath, J" sort="Wallmichrath, J" uniqKey="Wallmichrath J" first="J" last="Wallmichrath">J. Wallmichrath</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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