Lymphatic microsurgery for the treatment of lymphedema.
Identifieur interne : 002112 ( Ncbi/Merge ); précédent : 002111; suivant : 002113Lymphatic microsurgery for the treatment of lymphedema.
Auteurs : C. Campisi [Italie] ; D. Davini ; C. Bellini ; G. Taddei ; G. Villa ; E. Fulcheri ; A. Zilli ; E. Da Rin ; C. Eretta ; F. BoccardoSource :
- Microsurgery [ 0738-1085 ] ; 2006.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Anastomose chirurgicale (), Enfant, Enfant d'âge préscolaire, Facteurs temps, Femelle, Humains, Lymphoedème (), Lymphoedème (diagnostic), Lymphoedème (étiologie), Microchirurgie (), Mâle, Résultat thérapeutique, Sujet âgé, Vaisseaux lymphatiques (), Études de suivi, Études rétrospectives.
- MESH :
- diagnostic : Lymphoedème.
- étiologie : Lymphoedème.
- Adolescent, Adulte, Adulte d'âge moyen, Anastomose chirurgicale, Enfant, Enfant d'âge préscolaire, Facteurs temps, Femelle, Humains, Lymphoedème, Microchirurgie, Mâle, Résultat thérapeutique, Sujet âgé, Vaisseaux lymphatiques, Études de suivi, Études rétrospectives.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Anastomosis, Surgical (methods), Child, Child, Preschool, Female, Follow-Up Studies, Humans, Lymphatic Vessels (surgery), Lymphedema (diagnosis), Lymphedema (etiology), Lymphedema (surgery), Male, Microsurgery (methods), Middle Aged, Retrospective Studies, Time Factors, Treatment Outcome.
- MESH :
- diagnosis : Lymphedema.
- etiology : Lymphedema.
- methods : Anastomosis, Surgical, Microsurgery.
- surgery : Lymphatic Vessels, Lymphedema.
- Adolescent, Adult, Aged, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, Treatment Outcome.
Abstract
One of the main problems of microsurgery for lymphedema consists of the discrepancy between the excellent technical possibilities and the subsequently insufficient reduction of the lymphoedematous tissue fibrosis and sclerosis. Appropriate treatment based on pathologic study and surgical outcome have not been adequately documented. Over the past 25 years, more than 1000 patients with peripheral lymphedema have been treated with microsurgical techniques. Derivative lymphatic micro-vascular procedures has today its most exemplary application in multiple lymphatic-venous anastomoses (LVA). For those cases where a venous disease is associated to more or less latent or manifest lymphostatic pathology of such severity to contraindicate a lymphatic-venous shunt, reconstructive lymphatic microsurgery techniques have been developed (autologous venous grafts or lymphatic-venous-Iymphatic-plasty - LVLA). Objective assessment was undertaken by water volumetry and lymphoscintigraphy. Subjective improvement was noted in 87% of patients. Objectively, volume changes showed a significant improvement in 83%, with an average reduction of 67% of the excess volume. Of those patients followed-up, 85% have been able to discontinue the use of conservative measures, with an average follow-up of more than 7 years and average reduction in excess volume of 69%. There was a 87% reduction in the incidence of cellulitis after microsurgery. Microsurgical lymphatic-venous anastomoses have a place in the treatment of peripheral lymphedema and should be the therapy of choice in patients who are not sufficiently responsive to nonsurgical treatment. Improved results can be expected with operations performed earlier at the very first stages of lymphedema.
DOI: 10.1002/micr.20214
PubMed: 16444753
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Campisi</name><affiliation wicri:level="1"><nlm:affiliation>Section of Lymphatic Surgery and Microsurgery, Department of Surgery, S. Martino Hospital, University of Genoa, Genoa, Italy. campisi@unige.it</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Section of Lymphatic Surgery and Microsurgery, Department of Surgery, S. Martino Hospital, University of Genoa, Genoa</wicri:regionArea><wicri:noRegion>Genoa</wicri:noRegion></affiliation></author><author><name sortKey="Davini, D" sort="Davini, D" uniqKey="Davini D" first="D" last="Davini">D. Davini</name></author><author><name sortKey="Bellini, C" sort="Bellini, C" uniqKey="Bellini C" first="C" last="Bellini">C. Bellini</name></author><author><name sortKey="Taddei, G" sort="Taddei, G" uniqKey="Taddei G" first="G" last="Taddei">G. Taddei</name></author><author><name sortKey="Villa, G" sort="Villa, G" uniqKey="Villa G" first="G" last="Villa">G. 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Boccardo</name></author></analytic><series><title level="j">Microsurgery</title><idno type="ISSN">0738-1085</idno><imprint><date when="2006" type="published">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Anastomosis, Surgical (methods)</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymphatic Vessels (surgery)</term><term>Lymphedema (diagnosis)</term><term>Lymphedema (etiology)</term><term>Lymphedema (surgery)</term><term>Male</term><term>Microsurgery (methods)</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Anastomose chirurgicale ()</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Lymphoedème ()</term><term>Lymphoedème (diagnostic)</term><term>Lymphoedème (étiologie)</term><term>Microchirurgie ()</term><term>Mâle</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Vaisseaux lymphatiques ()</term><term>Études de suivi</term><term>Études rétrospectives</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="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Anastomosis, Surgical</term><term>Microsurgery</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Lymphatic Vessels</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Anastomose chirurgicale</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Lymphoedème</term><term>Microchirurgie</term><term>Mâle</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Vaisseaux lymphatiques</term><term>Études de suivi</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">One of the main problems of microsurgery for lymphedema consists of the discrepancy between the excellent technical possibilities and the subsequently insufficient reduction of the lymphoedematous tissue fibrosis and sclerosis. Appropriate treatment based on pathologic study and surgical outcome have not been adequately documented. Over the past 25 years, more than 1000 patients with peripheral lymphedema have been treated with microsurgical techniques. Derivative lymphatic micro-vascular procedures has today its most exemplary application in multiple lymphatic-venous anastomoses (LVA). For those cases where a venous disease is associated to more or less latent or manifest lymphostatic pathology of such severity to contraindicate a lymphatic-venous shunt, reconstructive lymphatic microsurgery techniques have been developed (autologous venous grafts or lymphatic-venous-Iymphatic-plasty - LVLA). Objective assessment was undertaken by water volumetry and lymphoscintigraphy. Subjective improvement was noted in 87% of patients. Objectively, volume changes showed a significant improvement in 83%, with an average reduction of 67% of the excess volume. Of those patients followed-up, 85% have been able to discontinue the use of conservative measures, with an average follow-up of more than 7 years and average reduction in excess volume of 69%. There was a 87% reduction in the incidence of cellulitis after microsurgery. Microsurgical lymphatic-venous anastomoses have a place in the treatment of peripheral lymphedema and should be the therapy of choice in patients who are not sufficiently responsive to nonsurgical treatment. Improved results can be expected with operations performed earlier at the very first stages of lymphedema.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">16444753</PMID><DateCreated><Year>2006</Year><Month>02</Month><Day>02</Day></DateCreated><DateCompleted><Year>2006</Year><Month>08</Month><Day>01</Day></DateCompleted><DateRevised><Year>2006</Year><Month>02</Month><Day>02</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0738-1085</ISSN><JournalIssue CitedMedium="Print"><Volume>26</Volume><Issue>1</Issue><PubDate><Year>2006</Year></PubDate></JournalIssue><Title>Microsurgery</Title><ISOAbbreviation>Microsurgery</ISOAbbreviation></Journal><ArticleTitle>Lymphatic microsurgery for the treatment of lymphedema.</ArticleTitle><Pagination><MedlinePgn>65-9</MedlinePgn></Pagination><Abstract><AbstractText>One of the main problems of microsurgery for lymphedema consists of the discrepancy between the excellent technical possibilities and the subsequently insufficient reduction of the lymphoedematous tissue fibrosis and sclerosis. Appropriate treatment based on pathologic study and surgical outcome have not been adequately documented. Over the past 25 years, more than 1000 patients with peripheral lymphedema have been treated with microsurgical techniques. Derivative lymphatic micro-vascular procedures has today its most exemplary application in multiple lymphatic-venous anastomoses (LVA). For those cases where a venous disease is associated to more or less latent or manifest lymphostatic pathology of such severity to contraindicate a lymphatic-venous shunt, reconstructive lymphatic microsurgery techniques have been developed (autologous venous grafts or lymphatic-venous-Iymphatic-plasty - LVLA). Objective assessment was undertaken by water volumetry and lymphoscintigraphy. Subjective improvement was noted in 87% of patients. Objectively, volume changes showed a significant improvement in 83%, with an average reduction of 67% of the excess volume. Of those patients followed-up, 85% have been able to discontinue the use of conservative measures, with an average follow-up of more than 7 years and average reduction in excess volume of 69%. There was a 87% reduction in the incidence of cellulitis after microsurgery. Microsurgical lymphatic-venous anastomoses have a place in the treatment of peripheral lymphedema and should be the therapy of choice in patients who are not sufficiently responsive to nonsurgical treatment. Improved results can be expected with operations performed earlier at the very first stages of lymphedema.</AbstractText><CopyrightInformation>Copyright 2006 Wiley-Liss, Inc.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Campisi</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Section of Lymphatic Surgery and Microsurgery, Department of Surgery, S. Martino Hospital, University of Genoa, Genoa, Italy. campisi@unige.it</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Davini</LastName><ForeName>D</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Bellini</LastName><ForeName>C</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Taddei</LastName><ForeName>G</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Villa</LastName><ForeName>G</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Fulcheri</LastName><ForeName>E</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Zilli</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Da Rin</LastName><ForeName>E</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Eretta</LastName><ForeName>C</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Boccardo</LastName><ForeName>F</ForeName><Initials>F</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Microsurgery</MedlineTA><NlmUniqueID>8309230</NlmUniqueID><ISSNLinking>0738-1085</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000714" MajorTopicYN="N">Anastomosis, Surgical</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D042601" MajorTopicYN="N">Lymphatic Vessels</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008866" MajorTopicYN="N">Microsurgery</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2006</Year><Month>1</Month><Day>31</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2006</Year><Month>8</Month><Day>2</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2006</Year><Month>1</Month><Day>31</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">16444753</ArticleId><ArticleId IdType="doi">10.1002/micr.20214</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Italie</li></country></list><tree><noCountry><name sortKey="Bellini, C" sort="Bellini, C" uniqKey="Bellini C" first="C" last="Bellini">C. Bellini</name><name sortKey="Boccardo, F" sort="Boccardo, F" uniqKey="Boccardo F" first="F" last="Boccardo">F. Boccardo</name><name sortKey="Da Rin, E" sort="Da Rin, E" uniqKey="Da Rin E" first="E" last="Da Rin">E. Da Rin</name><name sortKey="Davini, D" sort="Davini, D" uniqKey="Davini D" first="D" last="Davini">D. Davini</name><name sortKey="Eretta, C" sort="Eretta, C" uniqKey="Eretta C" first="C" last="Eretta">C. Eretta</name><name sortKey="Fulcheri, E" sort="Fulcheri, E" uniqKey="Fulcheri E" first="E" last="Fulcheri">E. Fulcheri</name><name sortKey="Taddei, G" sort="Taddei, G" uniqKey="Taddei G" first="G" last="Taddei">G. Taddei</name><name sortKey="Villa, G" sort="Villa, G" uniqKey="Villa G" first="G" last="Villa">G. Villa</name><name sortKey="Zilli, A" sort="Zilli, A" uniqKey="Zilli A" first="A" last="Zilli">A. Zilli</name></noCountry><country name="Italie"><noRegion><name sortKey="Campisi, C" sort="Campisi, C" uniqKey="Campisi C" first="C" last="Campisi">C. 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