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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 : 000341 ( PascalFrancis/Corpus ); précédent : 000340; suivant : 000342

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

Auteurs : R. J. Damstra ; H. G. J. Voesten ; W. D. Van Schelven ; B. Van Der Lei

Source :

RBID : Pascal:09-0141914

Descripteurs français

English descriptors

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.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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A08 01  1  ENG  @1 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
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A11 02  1    @1 VOESTEN (H. G. J.)
A11 03  1    @1 VAN SCHELVEN (W. D.)
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A14 03      @1 Department of Nuclear Medicine, Medical Centre Leeuwarden @2 Leeuwarden @3 NLD @Z 3 aut.
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Format Inist (serveur)

NO : PASCAL 09-0141914 INIST
ET : 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
AU : DAMSTRA (R. J.); VOESTEN (H. G. J.); VAN SCHELVEN (W. D.); VAN DER LEI (B.)
AF : Department of Dermatology, Phlebology and Lymphology, Nij Smellinghe Hospital, Compagnonsplein 1/9202 NN Drachten/Pays-Bas (1 aut.); Department of Surgery, Nij Smellinghe Hospital/Drachten/Pays-Bas (2 aut.); Department of Nuclear Medicine, Medical Centre Leeuwarden/Leeuwarden/Pays-Bas (3 aut.); Department of Plastic Reconstructive, Aesthetic and Hand Surgery, University Medical Centre Groningen/Groningen/Pays-Bas (4 aut.)
DT : Publication en série; Niveau analytique
SO : Breast cancer research and treatment; ISSN 0167-6806; Coden BCTRD6; Pays-Bas; Da. 2009; Vol. 113; No. 2; Pp. 199-206; Bibl. 30 ref.
LA : Anglais
EA : 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.
CC : 002B20E02; 002B12B04
FD : Lymphatique; Système lymphatique; Veine; Traitement; Secondaire; Bras; Lymphoedème; Prospective; Procédure; Homme; Malade; Cancer du sein; Article synthèse; Revue bibliographique; Microchirurgie; Médecine factuelle; Scintigraphie; Eau; Lymphoscintigraphie
FG : Pratique basée sur des preuves; Appareil circulatoire; Vaisseau sanguin; Pathologie de l'appareil circulatoire; Pathologie des vaisseaux lymphatiques; Tumeur maligne; Cancer; Pathologie de la glande mammaire; Pathologie du sein; Chirurgie; Exploration radioisotopique; Imagerie médicale
ED : Lymphatic; Lymphatic system; Vein; Treatment; Secondary; Arm; Lymphedema; Prospective; Procedure; Human; Patient; Breast cancer; Review; Bibliographic review; Microsurgery; Evidence-based medicine; Scintigraphy; Water; Lymphoscintigraphy
EG : Evidence-based practice; Circulatory system; Blood vessel; Cardiovascular disease; Lymphatic vessel disease; Malignant tumor; Cancer; Mammary gland diseases; Breast disease; Surgery; Radionuclide study; Medical imagery
SD : Linfático; Sistema linfático; Vena; Tratamiento; Secundario; Brazo; Linfedema; Prospectiva; Procedimiento; Hombre; Enfermo; Cáncer del pecho; Artículo síntesis; Revista bibliográfica; Microcirugía; Medicina basada en pruebas; Centelleografía; Agua; Linfocentelleografía
LO : INIST-20699.354000186985230010
ID : 09-0141914

Links to Exploration step

Pascal:09-0141914

Le document en format XML

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<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>
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<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>
</fA14>
<fA14 i1="02">
<s1>Department of Surgery, Nij Smellinghe Hospital</s1>
<s2>Drachten</s2>
<s3>NLD</s3>
<sZ>2 aut.</sZ>
</fA14>
<fA14 i1="03">
<s1>Department of Nuclear Medicine, Medical Centre Leeuwarden</s1>
<s2>Leeuwarden</s2>
<s3>NLD</s3>
<sZ>3 aut.</sZ>
</fA14>
<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>
</fA14>
<fA20>
<s1>199-206</s1>
</fA20>
<fA21>
<s1>2009</s1>
</fA21>
<fA23 i1="01">
<s0>ENG</s0>
</fA23>
<fA43 i1="01">
<s1>INIST</s1>
<s2>20699</s2>
<s5>354000186985230010</s5>
</fA43>
<fA44>
<s0>0000</s0>
<s1>© 2009 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45>
<s0>30 ref.</s0>
</fA45>
<fA47 i1="01" i2="1">
<s0>09-0141914</s0>
</fA47>
<fA60>
<s1>P</s1>
</fA60>
<fA61>
<s0>A</s0>
</fA61>
<fA64 i1="01" i2="1">
<s0>Breast cancer research and treatment</s0>
</fA64>
<fA66 i1="01">
<s0>NLD</s0>
</fA66>
<fC01 i1="01" l="ENG">
<s0>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.</s0>
</fC01>
<fC02 i1="01" i2="X">
<s0>002B20E02</s0>
</fC02>
<fC02 i1="02" i2="X">
<s0>002B12B04</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE">
<s0>Lymphatique</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG">
<s0>Lymphatic</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA">
<s0>Linfático</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE">
<s0>Système lymphatique</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG">
<s0>Lymphatic system</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA">
<s0>Sistema linfático</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE">
<s0>Veine</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG">
<s0>Vein</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA">
<s0>Vena</s0>
<s5>03</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE">
<s0>Traitement</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG">
<s0>Treatment</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA">
<s0>Tratamiento</s0>
<s5>04</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE">
<s0>Secondaire</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG">
<s0>Secondary</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA">
<s0>Secundario</s0>
<s5>05</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE">
<s0>Bras</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG">
<s0>Arm</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA">
<s0>Brazo</s0>
<s5>06</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE">
<s0>Lymphoedème</s0>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG">
<s0>Lymphedema</s0>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA">
<s0>Linfedema</s0>
<s5>07</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE">
<s0>Prospective</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG">
<s0>Prospective</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA">
<s0>Prospectiva</s0>
<s5>08</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE">
<s0>Procédure</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG">
<s0>Procedure</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA">
<s0>Procedimiento</s0>
<s5>09</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE">
<s0>Homme</s0>
<s5>10</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG">
<s0>Human</s0>
<s5>10</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA">
<s0>Hombre</s0>
<s5>10</s5>
</fC03>
<fC03 i1="11" i2="X" l="FRE">
<s0>Malade</s0>
<s5>11</s5>
</fC03>
<fC03 i1="11" i2="X" l="ENG">
<s0>Patient</s0>
<s5>11</s5>
</fC03>
<fC03 i1="11" i2="X" l="SPA">
<s0>Enfermo</s0>
<s5>11</s5>
</fC03>
<fC03 i1="12" i2="X" l="FRE">
<s0>Cancer du sein</s0>
<s2>NM</s2>
<s5>12</s5>
</fC03>
<fC03 i1="12" i2="X" l="ENG">
<s0>Breast cancer</s0>
<s2>NM</s2>
<s5>12</s5>
</fC03>
<fC03 i1="12" i2="X" l="SPA">
<s0>Cáncer del pecho</s0>
<s2>NM</s2>
<s5>12</s5>
</fC03>
<fC03 i1="13" i2="X" l="FRE">
<s0>Article synthèse</s0>
<s5>13</s5>
</fC03>
<fC03 i1="13" i2="X" l="ENG">
<s0>Review</s0>
<s5>13</s5>
</fC03>
<fC03 i1="13" i2="X" l="SPA">
<s0>Artículo síntesis</s0>
<s5>13</s5>
</fC03>
<fC03 i1="14" i2="X" l="FRE">
<s0>Revue bibliographique</s0>
<s5>14</s5>
</fC03>
<fC03 i1="14" i2="X" l="ENG">
<s0>Bibliographic review</s0>
<s5>14</s5>
</fC03>
<fC03 i1="14" i2="X" l="SPA">
<s0>Revista bibliográfica</s0>
<s5>14</s5>
</fC03>
<fC03 i1="15" i2="X" l="FRE">
<s0>Microchirurgie</s0>
<s5>15</s5>
</fC03>
<fC03 i1="15" i2="X" l="ENG">
<s0>Microsurgery</s0>
<s5>15</s5>
</fC03>
<fC03 i1="15" i2="X" l="SPA">
<s0>Microcirugía</s0>
<s5>15</s5>
</fC03>
<fC03 i1="16" i2="X" l="FRE">
<s0>Médecine factuelle</s0>
<s5>16</s5>
</fC03>
<fC03 i1="16" i2="X" l="ENG">
<s0>Evidence-based medicine</s0>
<s5>16</s5>
</fC03>
<fC03 i1="16" i2="X" l="SPA">
<s0>Medicina basada en pruebas</s0>
<s5>16</s5>
</fC03>
<fC03 i1="17" i2="X" l="FRE">
<s0>Scintigraphie</s0>
<s5>17</s5>
</fC03>
<fC03 i1="17" i2="X" l="ENG">
<s0>Scintigraphy</s0>
<s5>17</s5>
</fC03>
<fC03 i1="17" i2="X" l="SPA">
<s0>Centelleografía</s0>
<s5>17</s5>
</fC03>
<fC03 i1="18" i2="X" l="FRE">
<s0>Eau</s0>
<s5>18</s5>
</fC03>
<fC03 i1="18" i2="X" l="ENG">
<s0>Water</s0>
<s5>18</s5>
</fC03>
<fC03 i1="18" i2="X" l="SPA">
<s0>Agua</s0>
<s5>18</s5>
</fC03>
<fC03 i1="19" i2="X" l="FRE">
<s0>Lymphoscintigraphie</s0>
<s4>CD</s4>
<s5>96</s5>
</fC03>
<fC03 i1="19" i2="X" l="ENG">
<s0>Lymphoscintigraphy</s0>
<s4>CD</s4>
<s5>96</s5>
</fC03>
<fC03 i1="19" i2="X" l="SPA">
<s0>Linfocentelleografía</s0>
<s4>CD</s4>
<s5>96</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE">
<s0>Pratique basée sur des preuves</s0>
</fC07>
<fC07 i1="01" i2="X" l="ENG">
<s0>Evidence-based practice</s0>
</fC07>
<fC07 i1="01" i2="X" l="SPA">
<s0>Práctica basada en la evidencia</s0>
</fC07>
<fC07 i1="02" i2="X" l="FRE">
<s0>Appareil circulatoire</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG">
<s0>Circulatory system</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA">
<s0>Aparato circulatorio</s0>
<s5>37</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE">
<s0>Vaisseau sanguin</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG">
<s0>Blood vessel</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA">
<s0>Vaso sanguíneo</s0>
<s5>38</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE">
<s0>Pathologie de l'appareil circulatoire</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG">
<s0>Cardiovascular disease</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA">
<s0>Aparato circulatorio patología</s0>
<s5>39</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE">
<s0>Pathologie des vaisseaux lymphatiques</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG">
<s0>Lymphatic vessel disease</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA">
<s0>Linfático patología</s0>
<s5>40</s5>
</fC07>
<fC07 i1="06" i2="X" l="FRE">
<s0>Tumeur maligne</s0>
<s2>NM</s2>
<s5>41</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG">
<s0>Malignant tumor</s0>
<s2>NM</s2>
<s5>41</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA">
<s0>Tumor maligno</s0>
<s2>NM</s2>
<s5>41</s5>
</fC07>
<fC07 i1="07" i2="X" l="FRE">
<s0>Cancer</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="07" i2="X" l="ENG">
<s0>Cancer</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="07" i2="X" l="SPA">
<s0>Cáncer</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="08" i2="X" l="FRE">
<s0>Pathologie de la glande mammaire</s0>
<s2>NM</s2>
<s5>42</s5>
</fC07>
<fC07 i1="08" i2="X" l="ENG">
<s0>Mammary gland diseases</s0>
<s2>NM</s2>
<s5>42</s5>
</fC07>
<fC07 i1="08" i2="X" l="SPA">
<s0>Glándula mamaria patología</s0>
<s2>NM</s2>
<s5>42</s5>
</fC07>
<fC07 i1="09" i2="X" l="FRE">
<s0>Pathologie du sein</s0>
<s2>NM</s2>
<s5>43</s5>
</fC07>
<fC07 i1="09" i2="X" l="ENG">
<s0>Breast disease</s0>
<s2>NM</s2>
<s5>43</s5>
</fC07>
<fC07 i1="09" i2="X" l="SPA">
<s0>Seno patología</s0>
<s2>NM</s2>
<s5>43</s5>
</fC07>
<fC07 i1="10" i2="X" l="FRE">
<s0>Chirurgie</s0>
<s5>44</s5>
</fC07>
<fC07 i1="10" i2="X" l="ENG">
<s0>Surgery</s0>
<s5>44</s5>
</fC07>
<fC07 i1="10" i2="X" l="SPA">
<s0>Cirugía</s0>
<s5>44</s5>
</fC07>
<fC07 i1="11" i2="X" l="FRE">
<s0>Exploration radioisotopique</s0>
<s5>45</s5>
</fC07>
<fC07 i1="11" i2="X" l="ENG">
<s0>Radionuclide study</s0>
<s5>45</s5>
</fC07>
<fC07 i1="11" i2="X" l="SPA">
<s0>Exploración radioisotópica</s0>
<s5>45</s5>
</fC07>
<fC07 i1="12" i2="X" l="FRE">
<s0>Imagerie médicale</s0>
<s5>46</s5>
</fC07>
<fC07 i1="12" i2="X" l="ENG">
<s0>Medical imagery</s0>
<s5>46</s5>
</fC07>
<fC07 i1="12" i2="X" l="SPA">
<s0>Imaginería médica</s0>
<s5>46</s5>
</fC07>
<fN21>
<s1>096</s1>
</fN21>
<fN44 i1="01">
<s1>OTO</s1>
</fN44>
<fN82>
<s1>OTO</s1>
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</pA>
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<server>
<NO>PASCAL 09-0141914 INIST</NO>
<ET>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</ET>
<AU>DAMSTRA (R. J.); VOESTEN (H. G. J.); VAN SCHELVEN (W. D.); VAN DER LEI (B.)</AU>
<AF>Department of Dermatology, Phlebology and Lymphology, Nij Smellinghe Hospital, Compagnonsplein 1/9202 NN Drachten/Pays-Bas (1 aut.); Department of Surgery, Nij Smellinghe Hospital/Drachten/Pays-Bas (2 aut.); Department of Nuclear Medicine, Medical Centre Leeuwarden/Leeuwarden/Pays-Bas (3 aut.); Department of Plastic Reconstructive, Aesthetic and Hand Surgery, University Medical Centre Groningen/Groningen/Pays-Bas (4 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Breast cancer research and treatment; ISSN 0167-6806; Coden BCTRD6; Pays-Bas; Da. 2009; Vol. 113; No. 2; Pp. 199-206; Bibl. 30 ref.</SO>
<LA>Anglais</LA>
<EA>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.</EA>
<CC>002B20E02; 002B12B04</CC>
<FD>Lymphatique; Système lymphatique; Veine; Traitement; Secondaire; Bras; Lymphoedème; Prospective; Procédure; Homme; Malade; Cancer du sein; Article synthèse; Revue bibliographique; Microchirurgie; Médecine factuelle; Scintigraphie; Eau; Lymphoscintigraphie</FD>
<FG>Pratique basée sur des preuves; Appareil circulatoire; Vaisseau sanguin; Pathologie de l'appareil circulatoire; Pathologie des vaisseaux lymphatiques; Tumeur maligne; Cancer; Pathologie de la glande mammaire; Pathologie du sein; Chirurgie; Exploration radioisotopique; Imagerie médicale</FG>
<ED>Lymphatic; Lymphatic system; Vein; Treatment; Secondary; Arm; Lymphedema; Prospective; Procedure; Human; Patient; Breast cancer; Review; Bibliographic review; Microsurgery; Evidence-based medicine; Scintigraphy; Water; Lymphoscintigraphy</ED>
<EG>Evidence-based practice; Circulatory system; Blood vessel; Cardiovascular disease; Lymphatic vessel disease; Malignant tumor; Cancer; Mammary gland diseases; Breast disease; Surgery; Radionuclide study; Medical imagery</EG>
<SD>Linfático; Sistema linfático; Vena; Tratamiento; Secundario; Brazo; Linfedema; Prospectiva; Procedimiento; Hombre; Enfermo; Cáncer del pecho; Artículo síntesis; Revista bibliográfica; Microcirugía; Medicina basada en pruebas; Centelleografía; Agua; Linfocentelleografía</SD>
<LO>INIST-20699.354000186985230010</LO>
<ID>09-0141914</ID>
</server>
</inist>
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