Modern therapeutic approaches to postmastectomy brachial lymphedema.
Identifieur interne : 00B260 ( Ncbi/Merge ); précédent : 00B259; suivant : 00B261Modern therapeutic approaches to postmastectomy brachial lymphedema.
Auteurs : M. Filippetti [Italie] ; E. Santoro ; F. Graziano ; M. Petric ; G. RinaldiSource :
- Microsurgery [ 0738-1085 ] ; 1994.
Descripteurs français
- KwdFr :
- MESH :
- effets indésirables : Lymphadénectomie, Mastectomie radicale.
- étiologie : Lymphoedème.
- Aisselle, Bras, Femelle, Humains, Lymphoedème, Microchirurgie, Études de suivi.
English descriptors
- KwdEn :
- MESH :
- adverse effects : Lymph Node Excision, Mastectomy, Radical.
- etiology : Lymphedema.
- methods : Microsurgery.
- surgery : Lymphedema.
- Arm, Axilla, Female, Follow-Up Studies, Humans.
Abstract
Over the past 10 years we have treated 36 patients affected by upper limb lymphedema, associated with mastectomy and axillary dissection, by either macrosurgical exeresis or microsurgical techniques. All cases had been unresponsive to prior drug or physical therapy (pressure and thermal therapy). Preoperative upper limb status was thoroughly examined by evaluating volume measurements, dynamic lymphoscintigraphy, venous Doppler fluximetry, ultrasonography, and nuclear magnetic resonance. Selected tests were repeated during follow-up to obtain more statistically significant results. Twenty-five of the 36 patients in our series presented a grade II lymphedema and underwent Degni-Cordeiro's microsurgical indirect lymphatico-venous shunt (L.V.S.) surgery. Fifteen of the 25 also received fasciotomies performed along the posterior aspect of the forearm. Three of the 36 patients presented grade II lymphedema and upper limb venous hypertension. These were treated with multiple fasciotomies alone. The remaining eight patients presented grade III lymphedemas. Seven underwent Kondoleon's partial superficial lymphangectomy, and one was treated with Servelle's total superficial lymphangectomy. Of the 36 patients who underwent surgery, only 27 were checked at 6 months; 22 were seen at 18 months. The remaining patients were followed up for too short of a period of time to be considered. Results were arranged into three groups. Classification criteria were: reduction of upper limb dimensions and the presence of the pre-existing symptoms (episodes of lymphangitis, pain, functional deficits. Results were considered good (class 3), fair (class 2), or poor (class 1). A positive clinical picture (class 2-3) was seen in 74% (20/27) at 6 months and in 59% (13/22) at 18 months.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed: 7830545
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Graziano</name></author><author><name sortKey="Petric, M" sort="Petric, M" uniqKey="Petric M" first="M" last="Petric">M. Petric</name></author><author><name sortKey="Rinaldi, G" sort="Rinaldi, G" uniqKey="Rinaldi G" first="G" last="Rinaldi">G. 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Rinaldi</name></author></analytic><series><title level="j">Microsurgery</title><idno type="ISSN">0738-1085</idno><imprint><date when="1994" type="published">1994</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arm</term><term>Axilla</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymph Node Excision (adverse effects)</term><term>Lymphedema (etiology)</term><term>Lymphedema (surgery)</term><term>Mastectomy, Radical (adverse effects)</term><term>Microsurgery (methods)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Aisselle</term><term>Bras</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie (effets indésirables)</term><term>Lymphoedème ()</term><term>Lymphoedème (étiologie)</term><term>Mastectomie radicale (effets indésirables)</term><term>Microchirurgie ()</term><term>Études de suivi</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Lymph Node Excision</term><term>Mastectomy, Radical</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Lymphadénectomie</term><term>Mastectomie radicale</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Microsurgery</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Arm</term><term>Axilla</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Aisselle</term><term>Bras</term><term>Femelle</term><term>Humains</term><term>Lymphoedème</term><term>Microchirurgie</term><term>Études de suivi</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Over the past 10 years we have treated 36 patients affected by upper limb lymphedema, associated with mastectomy and axillary dissection, by either macrosurgical exeresis or microsurgical techniques. All cases had been unresponsive to prior drug or physical therapy (pressure and thermal therapy). Preoperative upper limb status was thoroughly examined by evaluating volume measurements, dynamic lymphoscintigraphy, venous Doppler fluximetry, ultrasonography, and nuclear magnetic resonance. Selected tests were repeated during follow-up to obtain more statistically significant results. Twenty-five of the 36 patients in our series presented a grade II lymphedema and underwent Degni-Cordeiro's microsurgical indirect lymphatico-venous shunt (L.V.S.) surgery. Fifteen of the 25 also received fasciotomies performed along the posterior aspect of the forearm. Three of the 36 patients presented grade II lymphedema and upper limb venous hypertension. These were treated with multiple fasciotomies alone. The remaining eight patients presented grade III lymphedemas. Seven underwent Kondoleon's partial superficial lymphangectomy, and one was treated with Servelle's total superficial lymphangectomy. Of the 36 patients who underwent surgery, only 27 were checked at 6 months; 22 were seen at 18 months. The remaining patients were followed up for too short of a period of time to be considered. Results were arranged into three groups. Classification criteria were: reduction of upper limb dimensions and the presence of the pre-existing symptoms (episodes of lymphangitis, pain, functional deficits. Results were considered good (class 3), fair (class 2), or poor (class 1). A positive clinical picture (class 2-3) was seen in 74% (20/27) at 6 months and in 59% (13/22) at 18 months.(ABSTRACT TRUNCATED AT 250 WORDS)</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">7830545</PMID><DateCreated><Year>1995</Year><Month>02</Month><Day>17</Day></DateCreated><DateCompleted><Year>1995</Year><Month>02</Month><Day>17</Day></DateCompleted><DateRevised><Year>2004</Year><Month>11</Month><Day>17</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0738-1085</ISSN><JournalIssue CitedMedium="Print"><Volume>15</Volume><Issue>8</Issue><PubDate><Year>1994</Year></PubDate></JournalIssue><Title>Microsurgery</Title><ISOAbbreviation>Microsurgery</ISOAbbreviation></Journal><ArticleTitle>Modern therapeutic approaches to postmastectomy brachial lymphedema.</ArticleTitle><Pagination><MedlinePgn>604-10</MedlinePgn></Pagination><Abstract><AbstractText>Over the past 10 years we have treated 36 patients affected by upper limb lymphedema, associated with mastectomy and axillary dissection, by either macrosurgical exeresis or microsurgical techniques. All cases had been unresponsive to prior drug or physical therapy (pressure and thermal therapy). Preoperative upper limb status was thoroughly examined by evaluating volume measurements, dynamic lymphoscintigraphy, venous Doppler fluximetry, ultrasonography, and nuclear magnetic resonance. Selected tests were repeated during follow-up to obtain more statistically significant results. Twenty-five of the 36 patients in our series presented a grade II lymphedema and underwent Degni-Cordeiro's microsurgical indirect lymphatico-venous shunt (L.V.S.) surgery. Fifteen of the 25 also received fasciotomies performed along the posterior aspect of the forearm. Three of the 36 patients presented grade II lymphedema and upper limb venous hypertension. These were treated with multiple fasciotomies alone. The remaining eight patients presented grade III lymphedemas. Seven underwent Kondoleon's partial superficial lymphangectomy, and one was treated with Servelle's total superficial lymphangectomy. Of the 36 patients who underwent surgery, only 27 were checked at 6 months; 22 were seen at 18 months. The remaining patients were followed up for too short of a period of time to be considered. Results were arranged into three groups. Classification criteria were: reduction of upper limb dimensions and the presence of the pre-existing symptoms (episodes of lymphangitis, pain, functional deficits. Results were considered good (class 3), fair (class 2), or poor (class 1). A positive clinical picture (class 2-3) was seen in 74% (20/27) at 6 months and in 59% (13/22) at 18 months.(ABSTRACT TRUNCATED AT 250 WORDS)</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Filippetti</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>II Department of Surgery, Regina Elena Cancer Institute, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Santoro</LastName><ForeName>E</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Graziano</LastName><ForeName>F</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Petric</LastName><ForeName>M</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Rinaldi</LastName><ForeName>G</ForeName><Initials>G</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D018848">Controlled Clinical Trial</PublicationType><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="D001132" MajorTopicYN="N">Arm</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001365" MajorTopicYN="N">Axilla</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="D008197" MajorTopicYN="N">Lymph Node Excision</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015409" MajorTopicYN="N">Mastectomy, Radical</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008866" MajorTopicYN="N">Microsurgery</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1994</Year><Month>1</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1994</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1994</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">7830545</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Italie</li></country><region><li>Latium</li></region><settlement><li>Rome</li></settlement></list><tree><noCountry><name sortKey="Graziano, F" sort="Graziano, F" uniqKey="Graziano F" first="F" last="Graziano">F. Graziano</name><name sortKey="Petric, M" sort="Petric, M" uniqKey="Petric M" first="M" last="Petric">M. Petric</name><name sortKey="Rinaldi, G" sort="Rinaldi, G" uniqKey="Rinaldi G" first="G" last="Rinaldi">G. Rinaldi</name><name sortKey="Santoro, E" sort="Santoro, E" uniqKey="Santoro E" first="E" last="Santoro">E. Santoro</name></noCountry><country name="Italie"><region name="Latium"><name sortKey="Filippetti, M" sort="Filippetti, M" uniqKey="Filippetti M" first="M" last="Filippetti">M. Filippetti</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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