Classification of lymphoscintigraphy and relevance to surgical indication for lymphaticovenous anastomosis in upper limb lymphedema.
Identifieur interne : 005044 ( Main/Merge ); précédent : 005043; suivant : 005045Classification of lymphoscintigraphy and relevance to surgical indication for lymphaticovenous anastomosis in upper limb lymphedema.
Auteurs : T. Mikami [Japon] ; M. Hosono ; Y. Yabuki ; Y. Yamamoto ; K. Yasumura ; H. Sawada ; K. Shizukuishi ; J. MaegawaSource :
- Lymphology [ 0024-7766 ] ; 2011.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- classification : Lymphoscintigraphy.
- diagnostic imaging : Lymphedema.
- methods : Anastomosis, Surgical.
- surgery : Breast Neoplasms, Lymphatic Vessels, Lymphedema, Postoperative Complications.
- Adult, Aged, 80 and over, Female, Humans, Male, Middle Aged, Upper Extremity.
Abstract
Upper limb lymphedema that develops after breast cancer surgery causes physical discomfort and psychological distress, and it can require both conservative and surgical treatment. Lymphaticovenous anastomosis has been reported to be an effective treatment; however the disease severity criteria that define indications for this treatment remain unclear. Here, we examined lymphoscintigraphic findings in 78 patients with secondary upper limb lymphedema and classified them into 5 major types (Type I-V) and 3 subtypes (Subtype E, L, and 0). Results revealed that this classification is related to the clinical stage scale of the International Society of Lymphology. Based on intraoperative examination findings in 20 of the 78 patients, lymphatic pressure is likely to be further elevated in Type II-V cases which are characterized by the presence of dermal back flow. Therefore, lymphaticovenous anastomosis should be considered as a treatment option for lymphedema in Type II-V cases. Furthermore, there are only limited lymph vessel sites usable for lymphaticovenous anastomosis in more severe lymphedema types [Types IV and Type V (which is characterized by dermal backflow only in the hand)]. The findings in Type IV-V cases suggest that therapeutic strategies for severe upper limb lymphedema need further consideration.
PubMed: 22458117
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Mikami</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Japan. zeong3@mac.com</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama</wicri:regionArea><wicri:noRegion>Yokohama</wicri:noRegion></affiliation></author><author><name sortKey="Hosono, M" sort="Hosono, M" uniqKey="Hosono M" first="M" last="Hosono">M. Hosono</name></author><author><name sortKey="Yabuki, Y" sort="Yabuki, Y" uniqKey="Yabuki Y" first="Y" last="Yabuki">Y. Yabuki</name></author><author><name sortKey="Yamamoto, Y" sort="Yamamoto, Y" uniqKey="Yamamoto Y" first="Y" last="Yamamoto">Y. Yamamoto</name></author><author><name sortKey="Yasumura, K" sort="Yasumura, K" uniqKey="Yasumura K" first="K" last="Yasumura">K. Yasumura</name></author><author><name sortKey="Sawada, H" sort="Sawada, H" uniqKey="Sawada H" first="H" last="Sawada">H. Sawada</name></author><author><name sortKey="Shizukuishi, K" sort="Shizukuishi, K" uniqKey="Shizukuishi K" first="K" last="Shizukuishi">K. Shizukuishi</name></author><author><name sortKey="Maegawa, J" sort="Maegawa, J" uniqKey="Maegawa J" first="J" last="Maegawa">J. Maegawa</name></author></analytic><series><title level="j">Lymphology</title><idno type="ISSN">0024-7766</idno><imprint><date when="2011" type="published">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged, 80 and over</term><term>Anastomosis, Surgical (methods)</term><term>Breast Neoplasms (surgery)</term><term>Female</term><term>Humans</term><term>Lymphatic Vessels (surgery)</term><term>Lymphedema (diagnostic imaging)</term><term>Lymphedema (surgery)</term><term>Lymphoscintigraphy (classification)</term><term>Male</term><term>Middle Aged</term><term>Postoperative Complications (surgery)</term><term>Upper Extremity</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Anastomose chirurgicale ()</term><term>Complications postopératoires ()</term><term>Femelle</term><term>Humains</term><term>Lymphoedème ()</term><term>Lymphoedème (imagerie diagnostique)</term><term>Lymphoscintigraphie ()</term><term>Membre supérieur</term><term>Mâle</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs du sein ()</term><term>Vaisseaux lymphatiques ()</term></keywords><keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Lymphoscintigraphy</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Anastomosis, Surgical</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Breast Neoplasms</term><term>Lymphatic Vessels</term><term>Lymphedema</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Upper Extremity</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Anastomose chirurgicale</term><term>Complications postopératoires</term><term>Femelle</term><term>Humains</term><term>Lymphoedème</term><term>Lymphoscintigraphie</term><term>Membre supérieur</term><term>Mâle</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs du sein</term><term>Vaisseaux lymphatiques</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Upper limb lymphedema that develops after breast cancer surgery causes physical discomfort and psychological distress, and it can require both conservative and surgical treatment. Lymphaticovenous anastomosis has been reported to be an effective treatment; however the disease severity criteria that define indications for this treatment remain unclear. Here, we examined lymphoscintigraphic findings in 78 patients with secondary upper limb lymphedema and classified them into 5 major types (Type I-V) and 3 subtypes (Subtype E, L, and 0). Results revealed that this classification is related to the clinical stage scale of the International Society of Lymphology. Based on intraoperative examination findings in 20 of the 78 patients, lymphatic pressure is likely to be further elevated in Type II-V cases which are characterized by the presence of dermal back flow. Therefore, lymphaticovenous anastomosis should be considered as a treatment option for lymphedema in Type II-V cases. Furthermore, there are only limited lymph vessel sites usable for lymphaticovenous anastomosis in more severe lymphedema types [Types IV and Type V (which is characterized by dermal backflow only in the hand)]. The findings in Type IV-V cases suggest that therapeutic strategies for severe upper limb lymphedema need further consideration.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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