Staged skin and subcutaneous excision for lymphedema : A favorable report of long-term results
Identifieur interne :
001041 ( PascalFrancis/Curation );
précédent :
001040;
suivant :
001042
Staged skin and subcutaneous excision for lymphedema : A favorable report of long-term results
Auteurs : T. A. Miller [
États-Unis] ;
L. E. Wyatt ;
G. H. RudkinSource :
-
Plastic and reconstructive surgery : (1963) [ 0032-1052 ] ; 1998.
RBID : Pascal:98-0491223
Descripteurs français
- Pascal (Inist)
- Lymphoedème,
Membre inférieur,
Exérèse,
Tissu souscutané,
Peau,
Technique,
Résultat,
Long terme,
Etude longitudinale,
Traitement,
Homme.
- Wicri :
English descriptors
- KwdEn :
- Exeresis,
Follow up study,
Human,
Long term,
Lower limb,
Lymphedema,
Result,
Skin,
Subcutaneous tissue,
Technique,
Treatment.
Abstract
Numerous surgical procedures have been proposed for the management of lymphedema. The postoperative results vary, and unfortunately none of the procedures are curative. As a result, some degree of recurrence of leg edema is seen in all patients postoperatively. Reported here is a long-term follow-up of patients with lower extremity' lymphedema managed by skin and subcutaneous tissue excision. Thirty-eight patients (6 male; 32 female) with lower extremity lymphedema have been followed up for an average of 14 (3 to 27) years after staged subcutaneous excisions performed beneath skin flaps. Seven patients had been treated previously by other procedures. Of the 38 lymphedema patients, 10 patients developed edema after pelvic or groin ablative surgery, radiation therapy, or both. Results were documented by various methods: physical examination, circumferential measurements, volume displacement, serial photography, lymphoscintigraphy, and patient survey, Of these, it is believed that photographs are the easiest and as representative as any other method, all of which have great variability. Of the 38 patients, 30 patients had significant and long-lasting reduction in extremity size associated with improved function and extremity contour. Episodes of recurrent cellulitis were reduced or completely eliminated. No differences in the long-term results were seen in patients with acquired as opposed to congenital lymphedema. Met did not have as much improvement as women, Two patients had no change iii leg swelling, and six patients (three men) had progressive swelling after surgery. Partial wound separation occurred immediately postoperatively in one patient, and three patients had loss (less than 2 cm) of the skin flap, all in the ankle region. None of these instances required further surgery, and no other significant complications were encountered, Staged skin and subcutaneous excision beneath skin flaps appears to provide long-lasting improvement for lower extremity lymphedema, regardless of cause, in the majority of patients treated.
pA |
A01 | 01 | 1 | | @0 0032-1052 |
---|
A03 | | 1 | | @0 Plast. reconstr. surg. : (1963) |
---|
A05 | | | | @2 102 |
---|
A06 | | | | @2 5 |
---|
A08 | 01 | 1 | ENG | @1 Staged skin and subcutaneous excision for lymphedema : A favorable report of long-term results |
---|
A11 | 01 | 1 | | @1 MILLER (T. A.) |
---|
A11 | 02 | 1 | | @1 WYATT (L. E.) |
---|
A11 | 03 | 1 | | @1 RUDKIN (G. H.) |
---|
A14 | 01 | | | @1 Plastic Surgery Section at the West Los Angeles VA Medical Center @3 USA |
---|
A14 | 02 | | | @1 Division of Plastic and Reconstructive Surgery, UCLA School of Medicine @3 USA |
---|
A20 | | | | @1 1486-1501 |
---|
A21 | | | | @1 1998 |
---|
A23 | 01 | | | @0 ENG |
---|
A43 | 01 | | | @1 INIST @2 11075 @5 354000070618320170 |
---|
A44 | | | | @0 0000 @1 © 1998 INIST-CNRS. All rights reserved. |
---|
A45 | | | | @0 47 ref. |
---|
A47 | 01 | 1 | | @0 98-0491223 |
---|
A60 | | | | @1 P @2 C @3 AR @3 CT |
---|
A61 | | | | @0 A |
---|
A64 | | 1 | | @0 Plastic and reconstructive surgery : (1963) |
---|
A66 | 01 | | | @0 USA |
---|
C01 | 01 | | ENG | @0 Numerous surgical procedures have been proposed for the management of lymphedema. The postoperative results vary, and unfortunately none of the procedures are curative. As a result, some degree of recurrence of leg edema is seen in all patients postoperatively. Reported here is a long-term follow-up of patients with lower extremity' lymphedema managed by skin and subcutaneous tissue excision. Thirty-eight patients (6 male; 32 female) with lower extremity lymphedema have been followed up for an average of 14 (3 to 27) years after staged subcutaneous excisions performed beneath skin flaps. Seven patients had been treated previously by other procedures. Of the 38 lymphedema patients, 10 patients developed edema after pelvic or groin ablative surgery, radiation therapy, or both. Results were documented by various methods: physical examination, circumferential measurements, volume displacement, serial photography, lymphoscintigraphy, and patient survey, Of these, it is believed that photographs are the easiest and as representative as any other method, all of which have great variability. Of the 38 patients, 30 patients had significant and long-lasting reduction in extremity size associated with improved function and extremity contour. Episodes of recurrent cellulitis were reduced or completely eliminated. No differences in the long-term results were seen in patients with acquired as opposed to congenital lymphedema. Met did not have as much improvement as women, Two patients had no change iii leg swelling, and six patients (three men) had progressive swelling after surgery. Partial wound separation occurred immediately postoperatively in one patient, and three patients had loss (less than 2 cm) of the skin flap, all in the ankle region. None of these instances required further surgery, and no other significant complications were encountered, Staged skin and subcutaneous excision beneath skin flaps appears to provide long-lasting improvement for lower extremity lymphedema, regardless of cause, in the majority of patients treated. |
---|
C02 | 01 | X | | @0 002B25A |
---|
C03 | 01 | X | FRE | @0 Lymphoedème @5 01 |
---|
C03 | 01 | X | ENG | @0 Lymphedema @5 01 |
---|
C03 | 01 | X | SPA | @0 Linfedema @5 01 |
---|
C03 | 02 | X | FRE | @0 Membre inférieur @5 02 |
---|
C03 | 02 | X | ENG | @0 Lower limb @5 02 |
---|
C03 | 02 | X | SPA | @0 Miembro inferior @5 02 |
---|
C03 | 03 | X | FRE | @0 Exérèse @5 04 |
---|
C03 | 03 | X | ENG | @0 Exeresis @5 04 |
---|
C03 | 03 | X | SPA | @0 Exéresis @5 04 |
---|
C03 | 04 | X | FRE | @0 Tissu souscutané @5 05 |
---|
C03 | 04 | X | ENG | @0 Subcutaneous tissue @5 05 |
---|
C03 | 04 | X | SPA | @0 Tejido subcutáneo @5 05 |
---|
C03 | 05 | X | FRE | @0 Peau @5 06 |
---|
C03 | 05 | X | ENG | @0 Skin @5 06 |
---|
C03 | 05 | X | SPA | @0 Piel @5 06 |
---|
C03 | 06 | X | FRE | @0 Technique @5 07 |
---|
C03 | 06 | X | ENG | @0 Technique @5 07 |
---|
C03 | 06 | X | SPA | @0 Técnica @5 07 |
---|
C03 | 07 | X | FRE | @0 Résultat @5 08 |
---|
C03 | 07 | X | ENG | @0 Result @5 08 |
---|
C03 | 07 | X | SPA | @0 Resultado @5 08 |
---|
C03 | 08 | X | FRE | @0 Long terme @5 09 |
---|
C03 | 08 | X | ENG | @0 Long term @5 09 |
---|
C03 | 08 | X | SPA | @0 Largo plazo @5 09 |
---|
C03 | 09 | X | FRE | @0 Etude longitudinale @5 16 |
---|
C03 | 09 | X | ENG | @0 Follow up study @5 16 |
---|
C03 | 09 | X | SPA | @0 Estudio longitudinal @5 16 |
---|
C03 | 10 | X | FRE | @0 Traitement @5 17 |
---|
C03 | 10 | X | ENG | @0 Treatment @5 17 |
---|
C03 | 10 | X | GER | @0 Aufbereiten @5 17 |
---|
C03 | 10 | X | SPA | @0 Tratamiento @5 17 |
---|
C03 | 11 | X | FRE | @0 Homme @5 20 |
---|
C03 | 11 | X | ENG | @0 Human @5 20 |
---|
C03 | 11 | X | SPA | @0 Hombre @5 20 |
---|
C07 | 01 | X | FRE | @0 Appareil circulatoire pathologie @5 37 |
---|
C07 | 01 | X | ENG | @0 Cardiovascular disease @5 37 |
---|
C07 | 01 | X | SPA | @0 Aparato circulatorio patología @5 37 |
---|
C07 | 02 | X | FRE | @0 Lymphatique pathologie @5 38 |
---|
C07 | 02 | X | ENG | @0 Lymphatic vessel disease @5 38 |
---|
C07 | 02 | X | SPA | @0 Linfático patología @5 38 |
---|
C07 | 03 | X | FRE | @0 Chirurgie @5 45 |
---|
C07 | 03 | X | ENG | @0 Surgery @5 45 |
---|
C07 | 03 | X | SPA | @0 Cirugía @5 45 |
---|
N21 | | | | @1 320 |
---|
|
pR |
A30 | 01 | 1 | ENG | @1 Annual Meeting of the American Association of Plastic Surgeons @2 76 @3 Portland USA @4 1997-05 |
---|
|
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Le document en format XML
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<author><name sortKey="Miller, T A" sort="Miller, T A" uniqKey="Miller T" first="T. A." last="Miller">T. A. Miller</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Plastic Surgery Section at the West Los Angeles VA Medical Center</s1>
<s3>USA</s3>
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<country>États-Unis</country>
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<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Division of Plastic and Reconstructive Surgery, UCLA School of Medicine</s1>
<s3>USA</s3>
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<country>États-Unis</country>
</affiliation>
</author>
<author><name sortKey="Wyatt, L E" sort="Wyatt, L E" uniqKey="Wyatt L" first="L. E." last="Wyatt">L. E. Wyatt</name>
</author>
<author><name sortKey="Rudkin, G H" sort="Rudkin, G H" uniqKey="Rudkin G" first="G. H." last="Rudkin">G. H. Rudkin</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Staged skin and subcutaneous excision for lymphedema : A favorable report of long-term results</title>
<author><name sortKey="Miller, T A" sort="Miller, T A" uniqKey="Miller T" first="T. A." last="Miller">T. A. Miller</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Plastic Surgery Section at the West Los Angeles VA Medical Center</s1>
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<series><title level="j" type="main">Plastic and reconstructive surgery : (1963)</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Exeresis</term>
<term>Follow up study</term>
<term>Human</term>
<term>Long term</term>
<term>Lower limb</term>
<term>Lymphedema</term>
<term>Result</term>
<term>Skin</term>
<term>Subcutaneous tissue</term>
<term>Technique</term>
<term>Treatment</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Lymphoedème</term>
<term>Membre inférieur</term>
<term>Exérèse</term>
<term>Tissu souscutané</term>
<term>Peau</term>
<term>Technique</term>
<term>Résultat</term>
<term>Long terme</term>
<term>Etude longitudinale</term>
<term>Traitement</term>
<term>Homme</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
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<front><div type="abstract" xml:lang="en">Numerous surgical procedures have been proposed for the management of lymphedema. The postoperative results vary, and unfortunately none of the procedures are curative. As a result, some degree of recurrence of leg edema is seen in all patients postoperatively. Reported here is a long-term follow-up of patients with lower extremity' lymphedema managed by skin and subcutaneous tissue excision. Thirty-eight patients (6 male; 32 female) with lower extremity lymphedema have been followed up for an average of 14 (3 to 27) years after staged subcutaneous excisions performed beneath skin flaps. Seven patients had been treated previously by other procedures. Of the 38 lymphedema patients, 10 patients developed edema after pelvic or groin ablative surgery, radiation therapy, or both. Results were documented by various methods: physical examination, circumferential measurements, volume displacement, serial photography, lymphoscintigraphy, and patient survey, Of these, it is believed that photographs are the easiest and as representative as any other method, all of which have great variability. Of the 38 patients, 30 patients had significant and long-lasting reduction in extremity size associated with improved function and extremity contour. Episodes of recurrent cellulitis were reduced or completely eliminated. No differences in the long-term results were seen in patients with acquired as opposed to congenital lymphedema. Met did not have as much improvement as women, Two patients had no change iii leg swelling, and six patients (three men) had progressive swelling after surgery. Partial wound separation occurred immediately postoperatively in one patient, and three patients had loss (less than 2 cm) of the skin flap, all in the ankle region. None of these instances required further surgery, and no other significant complications were encountered, Staged skin and subcutaneous excision beneath skin flaps appears to provide long-lasting improvement for lower extremity lymphedema, regardless of cause, in the majority of patients treated.</div>
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<fA14 i1="01"><s1>Plastic Surgery Section at the West Los Angeles VA Medical Center</s1>
<s3>USA</s3>
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<fA14 i1="02"><s1>Division of Plastic and Reconstructive Surgery, UCLA School of Medicine</s1>
<s3>USA</s3>
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<fC01 i1="01" l="ENG"><s0>Numerous surgical procedures have been proposed for the management of lymphedema. The postoperative results vary, and unfortunately none of the procedures are curative. As a result, some degree of recurrence of leg edema is seen in all patients postoperatively. Reported here is a long-term follow-up of patients with lower extremity' lymphedema managed by skin and subcutaneous tissue excision. Thirty-eight patients (6 male; 32 female) with lower extremity lymphedema have been followed up for an average of 14 (3 to 27) years after staged subcutaneous excisions performed beneath skin flaps. Seven patients had been treated previously by other procedures. Of the 38 lymphedema patients, 10 patients developed edema after pelvic or groin ablative surgery, radiation therapy, or both. Results were documented by various methods: physical examination, circumferential measurements, volume displacement, serial photography, lymphoscintigraphy, and patient survey, Of these, it is believed that photographs are the easiest and as representative as any other method, all of which have great variability. Of the 38 patients, 30 patients had significant and long-lasting reduction in extremity size associated with improved function and extremity contour. Episodes of recurrent cellulitis were reduced or completely eliminated. No differences in the long-term results were seen in patients with acquired as opposed to congenital lymphedema. Met did not have as much improvement as women, Two patients had no change iii leg swelling, and six patients (three men) had progressive swelling after surgery. Partial wound separation occurred immediately postoperatively in one patient, and three patients had loss (less than 2 cm) of the skin flap, all in the ankle region. None of these instances required further surgery, and no other significant complications were encountered, Staged skin and subcutaneous excision beneath skin flaps appears to provide long-lasting improvement for lower extremity lymphedema, regardless of cause, in the majority of patients treated.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B25A</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>Lymphoedème</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Lymphedema</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>Linfedema</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE"><s0>Membre inférieur</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG"><s0>Lower limb</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA"><s0>Miembro inferior</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE"><s0>Exérèse</s0>
<s5>04</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Exeresis</s0>
<s5>04</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA"><s0>Exéresis</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Tissu souscutané</s0>
<s5>05</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Subcutaneous tissue</s0>
<s5>05</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Tejido subcutáneo</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Peau</s0>
<s5>06</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Skin</s0>
<s5>06</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Piel</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Technique</s0>
<s5>07</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Technique</s0>
<s5>07</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Técnica</s0>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Résultat</s0>
<s5>08</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Result</s0>
<s5>08</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Resultado</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Long terme</s0>
<s5>09</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Long term</s0>
<s5>09</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Largo plazo</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Etude longitudinale</s0>
<s5>16</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Follow up study</s0>
<s5>16</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Estudio longitudinal</s0>
<s5>16</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE"><s0>Traitement</s0>
<s5>17</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG"><s0>Treatment</s0>
<s5>17</s5>
</fC03>
<fC03 i1="10" i2="X" l="GER"><s0>Aufbereiten</s0>
<s5>17</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA"><s0>Tratamiento</s0>
<s5>17</s5>
</fC03>
<fC03 i1="11" i2="X" l="FRE"><s0>Homme</s0>
<s5>20</s5>
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<fC03 i1="11" i2="X" l="ENG"><s0>Human</s0>
<s5>20</s5>
</fC03>
<fC03 i1="11" i2="X" l="SPA"><s0>Hombre</s0>
<s5>20</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Appareil circulatoire pathologie</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Cardiovascular disease</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Lymphatique pathologie</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Lymphatic vessel disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Linfático patología</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Chirurgie</s0>
<s5>45</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Surgery</s0>
<s5>45</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Cirugía</s0>
<s5>45</s5>
</fC07>
<fN21><s1>320</s1>
</fN21>
</pA>
<pR><fA30 i1="01" i2="1" l="ENG"><s1>Annual Meeting of the American Association of Plastic Surgeons</s1>
<s2>76</s2>
<s3>Portland USA</s3>
<s4>1997-05</s4>
</fA30>
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|texte= Staged skin and subcutaneous excision for lymphedema : A favorable report of long-term results
}}
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