Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature
Identifieur interne : 006810 ( Main/Exploration ); précédent : 006809; suivant : 006811Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature
Auteurs : R. J. Damstra [Pays-Bas] ; H. G. J. Voesten [Pays-Bas] ; W. D. Van Schelven [Pays-Bas] ; B. Van Der Lei [Pays-Bas]Source :
- Breast cancer research and treatment [ 0167-6806 ] ; 2009.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Prospective, Homme, Eau.
English descriptors
- KwdEn :
Abstract
Objective The incidence of breast cancer related lymphedema (BCRL) varies between 7-35% depending on the combination of treatment modalities. Early detection of BCRL is crucial in order to start an effective non-operative treatment program. Because of the lack of prospective research on this topic, this study was undertaken to prospectively determine the effect of Lympho Venous Anastomosis (LVA) on BCRL and to review the current literature. Study design and methods Ten patients who were previously treated for breast cancer by surgery, radiotherapy, and chemotherapy, and were unresponsive to 12-weeks of non-operative treatment, underwent an LVA procedure (Degni-Cordeiro). Objective measurements were gathered for circumferential measurement and water volumetry, and quality of life. Various types of lymphoscintigraphy were carried out pre-operatively and post-operatively at 3 and 12 months. Treatment was embedded in a multidisciplinary setting. Results Post-operative volume measurements initially showed a 4.8% reduction of lymphedema at 3 months and a 2% reduction after one year. Various scintigraphic parameters showed some improvement. Quality of life questionnaires reported minimal improvement. Reviewing the literature, only retrospective studies were found; these reported varying results for LVA procedures. The selection of patients, classification of lymphedema, indications and types of LVA, and additional therapeutic options were heterogeneous, not comparable, and lacked a validated method of effect-assessment. Conclusions Our results showed a minimal reduction in volume of lymphedema following LVA; in the literature, there was no convincing evidence of the success of LVA. Non-operative treatment and elastic stockings are still preferred by most patients with lymphedema, especially in early stages with few irreversible changes.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature</title><author><name sortKey="Damstra, R J" sort="Damstra, R J" uniqKey="Damstra R" first="R. J." last="Damstra">R. J. Damstra</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Dermatology, Phlebology and Lymphology, Nij Smellinghe Hospital, Compagnonsplein 1</s1><s2>9202 NN Drachten</s2><s3>NLD</s3><sZ>1 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>9202 NN Drachten</wicri:noRegion></affiliation></author><author><name sortKey="Voesten, H G J" sort="Voesten, H G J" uniqKey="Voesten H" first="H. G. J." last="Voesten">H. G. J. Voesten</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Surgery, Nij Smellinghe Hospital</s1><s2>Drachten</s2><s3>NLD</s3><sZ>2 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Drachten</wicri:noRegion></affiliation></author><author><name sortKey="Van Schelven, W D" sort="Van Schelven, W D" uniqKey="Van Schelven W" first="W. D." last="Van Schelven">W. D. Van Schelven</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Nuclear Medicine, Medical Centre Leeuwarden</s1><s2>Leeuwarden</s2><s3>NLD</s3><sZ>3 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Leeuwarden</wicri:noRegion></affiliation></author><author><name sortKey="Van Der Lei, B" sort="Van Der Lei, B" uniqKey="Van Der Lei B" first="B." last="Van Der Lei">B. Van Der Lei</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Department of Plastic Reconstructive, Aesthetic and Hand Surgery, University Medical Centre Groningen</s1><s2>Groningen</s2><s3>NLD</s3><sZ>4 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0141914</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0141914 INIST</idno><idno type="RBID">Pascal:09-0141914</idno><idno type="wicri:Area/PascalFrancis/Corpus">000341</idno><idno type="wicri:Area/PascalFrancis/Curation">000617</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000326</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000326</idno><idno type="wicri:doubleKey">0167-6806:2009:Damstra R:lymphatic:venous:anastomosis</idno><idno type="wicri:Area/Main/Merge">006896</idno><idno type="wicri:Area/Main/Curation">006810</idno><idno type="wicri:Area/Main/Exploration">006810</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature</title><author><name sortKey="Damstra, R J" sort="Damstra, R J" uniqKey="Damstra R" first="R. J." last="Damstra">R. J. Damstra</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Dermatology, Phlebology and Lymphology, Nij Smellinghe Hospital, Compagnonsplein 1</s1><s2>9202 NN Drachten</s2><s3>NLD</s3><sZ>1 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>9202 NN Drachten</wicri:noRegion></affiliation></author><author><name sortKey="Voesten, H G J" sort="Voesten, H G J" uniqKey="Voesten H" first="H. G. J." last="Voesten">H. G. J. Voesten</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Surgery, Nij Smellinghe Hospital</s1><s2>Drachten</s2><s3>NLD</s3><sZ>2 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Drachten</wicri:noRegion></affiliation></author><author><name sortKey="Van Schelven, W D" sort="Van Schelven, W D" uniqKey="Van Schelven W" first="W. D." last="Van Schelven">W. D. Van Schelven</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Nuclear Medicine, Medical Centre Leeuwarden</s1><s2>Leeuwarden</s2><s3>NLD</s3><sZ>3 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Leeuwarden</wicri:noRegion></affiliation></author><author><name sortKey="Van Der Lei, B" sort="Van Der Lei, B" uniqKey="Van Der Lei B" first="B." last="Van Der Lei">B. Van Der Lei</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Department of Plastic Reconstructive, Aesthetic and Hand Surgery, University Medical Centre Groningen</s1><s2>Groningen</s2><s3>NLD</s3><sZ>4 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Breast cancer research and treatment</title><title level="j" type="abbreviated">Breast cancer res. treat.</title><idno type="ISSN">0167-6806</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Breast cancer research and treatment</title><title level="j" type="abbreviated">Breast cancer res. treat.</title><idno type="ISSN">0167-6806</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arm</term><term>Bibliographic review</term><term>Breast cancer</term><term>Evidence-based medicine</term><term>Human</term><term>Lymphatic</term><term>Lymphatic system</term><term>Lymphedema</term><term>Lymphoscintigraphy</term><term>Microsurgery</term><term>Patient</term><term>Procedure</term><term>Prospective</term><term>Review</term><term>Scintigraphy</term><term>Secondary</term><term>Treatment</term><term>Vein</term><term>Water</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Lymphatique</term><term>Système lymphatique</term><term>Veine</term><term>Traitement</term><term>Secondaire</term><term>Bras</term><term>Lymphoedème</term><term>Prospective</term><term>Procédure</term><term>Homme</term><term>Malade</term><term>Cancer du sein</term><term>Article synthèse</term><term>Revue bibliographique</term><term>Microchirurgie</term><term>Médecine factuelle</term><term>Scintigraphie</term><term>Eau</term><term>Lymphoscintigraphie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Prospective</term><term>Homme</term><term>Eau</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective The incidence of breast cancer related lymphedema (BCRL) varies between 7-35% depending on the combination of treatment modalities. Early detection of BCRL is crucial in order to start an effective non-operative treatment program. Because of the lack of prospective research on this topic, this study was undertaken to prospectively determine the effect of Lympho Venous Anastomosis (LVA) on BCRL and to review the current literature. Study design and methods Ten patients who were previously treated for breast cancer by surgery, radiotherapy, and chemotherapy, and were unresponsive to 12-weeks of non-operative treatment, underwent an LVA procedure (Degni-Cordeiro). Objective measurements were gathered for circumferential measurement and water volumetry, and quality of life. Various types of lymphoscintigraphy were carried out pre-operatively and post-operatively at 3 and 12 months. Treatment was embedded in a multidisciplinary setting. Results Post-operative volume measurements initially showed a 4.8% reduction of lymphedema at 3 months and a 2% reduction after one year. Various scintigraphic parameters showed some improvement. Quality of life questionnaires reported minimal improvement. Reviewing the literature, only retrospective studies were found; these reported varying results for LVA procedures. The selection of patients, classification of lymphedema, indications and types of LVA, and additional therapeutic options were heterogeneous, not comparable, and lacked a validated method of effect-assessment. Conclusions Our results showed a minimal reduction in volume of lymphedema following LVA; in the literature, there was no convincing evidence of the success of LVA. Non-operative treatment and elastic stockings are still preferred by most patients with lymphedema, especially in early stages with few irreversible changes.</div></front></TEI><affiliations><list><country><li>Pays-Bas</li></country><region><li>Groningue (province)</li></region><settlement><li>Groningue</li></settlement></list><tree><country name="Pays-Bas"><noRegion><name sortKey="Damstra, R J" sort="Damstra, R J" uniqKey="Damstra R" first="R. J." last="Damstra">R. J. Damstra</name></noRegion><name sortKey="Van Der Lei, B" sort="Van Der Lei, B" uniqKey="Van Der Lei B" first="B." last="Van Der Lei">B. Van Der Lei</name><name sortKey="Van Schelven, W D" sort="Van Schelven, W D" uniqKey="Van Schelven W" first="W. D." last="Van Schelven">W. D. Van Schelven</name><name sortKey="Voesten, H G J" sort="Voesten, H G J" uniqKey="Voesten H" first="H. G. J." last="Voesten">H. G. J. Voesten</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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