Lymphedema staging and surgical indications in geriatric age
Identifieur interne : 001D72 ( Pmc/Corpus ); précédent : 001D71; suivant : 001D73Lymphedema staging and surgical indications in geriatric age
Auteurs : C. Campisi ; C. Campisi ; S. Accogli ; C. Campisi ; F. BoccardoSource :
- BMC Geriatrics [ 1471-2318 ] ; 2010.
Abstract
Url:
DOI: 10.1186/1471-2318-10-S1-A50
PubMed: NONE
PubMed Central: 3290194
Links to Exploration step
PMC:3290194Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Lymphedema staging and surgical indications in geriatric age</title><author><name sortKey="Campisi, C" sort="Campisi, C" uniqKey="Campisi C" first="C" last="Campisi">C. Campisi</name><affiliation><nlm:aff id="I1">Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Italy</nlm:aff></affiliation></author><author><name sortKey="Campisi, C" sort="Campisi, C" uniqKey="Campisi C" first="C" last="Campisi">C. Campisi</name><affiliation><nlm:aff id="I1">Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Italy</nlm:aff></affiliation></author><author><name sortKey="Accogli, S" sort="Accogli, S" uniqKey="Accogli S" first="S" last="Accogli">S. Accogli</name><affiliation><nlm:aff id="I1">Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Italy</nlm:aff></affiliation></author><author><name sortKey="Campisi, C" sort="Campisi, C" uniqKey="Campisi C" first="C" last="Campisi">C. Campisi</name><affiliation><nlm:aff id="I1">Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Italy</nlm:aff></affiliation></author><author><name sortKey="Boccardo, F" sort="Boccardo, F" uniqKey="Boccardo F" first="F" last="Boccardo">F. Boccardo</name><affiliation><nlm:aff id="I1">Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Italy</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">3290194</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3290194</idno><idno type="RBID">PMC:3290194</idno><idno type="doi">10.1186/1471-2318-10-S1-A50</idno><idno type="pmid">NONE</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">001D72</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001D72</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Lymphedema staging and surgical indications in geriatric age</title><author><name sortKey="Campisi, C" sort="Campisi, C" uniqKey="Campisi C" first="C" last="Campisi">C. Campisi</name><affiliation><nlm:aff id="I1">Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Italy</nlm:aff></affiliation></author><author><name sortKey="Campisi, C" sort="Campisi, C" uniqKey="Campisi C" first="C" last="Campisi">C. Campisi</name><affiliation><nlm:aff id="I1">Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Italy</nlm:aff></affiliation></author><author><name sortKey="Accogli, S" sort="Accogli, S" uniqKey="Accogli S" first="S" last="Accogli">S. Accogli</name><affiliation><nlm:aff id="I1">Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Italy</nlm:aff></affiliation></author><author><name sortKey="Campisi, C" sort="Campisi, C" uniqKey="Campisi C" first="C" last="Campisi">C. Campisi</name><affiliation><nlm:aff id="I1">Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Italy</nlm:aff></affiliation></author><author><name sortKey="Boccardo, F" sort="Boccardo, F" uniqKey="Boccardo F" first="F" last="Boccardo">F. Boccardo</name><affiliation><nlm:aff id="I1">Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Italy</nlm:aff></affiliation></author></analytic><series><title level="j">BMC Geriatrics</title><idno type="eISSN">1471-2318</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title></title></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Dellacha, A" uniqKey="Dellacha A">A Dellachà</name></author><author><name sortKey="Boccardo, F" uniqKey="Boccardo F">F Boccardo</name></author><author><name sortKey="Zilli, A" uniqKey="Zilli A">A Zilli</name></author><author><name sortKey="Napoli, F" uniqKey="Napoli F">F Napoli</name></author><author><name sortKey="Fulcheri, E" uniqKey="Fulcheri E">E Fulcheri</name></author><author><name sortKey="Campisi, C" uniqKey="Campisi C">C Campisi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Campisi, C" uniqKey="Campisi C">C Campisi</name></author><author><name sortKey="Boccardo, F" uniqKey="Boccardo F">F Boccardo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Campisi, C" uniqKey="Campisi C">C Campisi</name></author><author><name sortKey="Boccardo, F" uniqKey="Boccardo F">F Boccardo</name></author><author><name sortKey="Tacchella, M" uniqKey="Tacchella M">M Tacchella</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="abstract"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Geriatr</journal-id><journal-title-group><journal-title>BMC Geriatrics</journal-title></journal-title-group><issn pub-type="epub">1471-2318</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">3290194</article-id><article-id pub-id-type="publisher-id">1471-2318-10-S1-A50</article-id><article-id pub-id-type="doi">10.1186/1471-2318-10-S1-A50</article-id><article-categories><subj-group subj-group-type="heading"><subject>Meeting abstract</subject></subj-group></article-categories><title-group><article-title>Lymphedema staging and surgical indications in geriatric age</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Campisi</surname><given-names>C</given-names></name><xref ref-type="aff" rid="I1">1</xref></contrib><contrib contrib-type="author" id="A2"><name><surname>Campisi</surname><given-names>C</given-names></name><xref ref-type="aff" rid="I1">1</xref></contrib><contrib contrib-type="author" id="A3"><name><surname>Accogli</surname><given-names>S</given-names></name><xref ref-type="aff" rid="I1">1</xref></contrib><contrib contrib-type="author" id="A4"><name><surname>Campisi</surname><given-names>C</given-names></name><xref ref-type="aff" rid="I1">1</xref></contrib><contrib contrib-type="author" id="A5"><name><surname>Boccardo</surname><given-names>F</given-names></name><xref ref-type="aff" rid="I1">1</xref></contrib></contrib-group><aff id="I1"><label>1</label>Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Italy</aff><pub-date pub-type="collection"><year>2010</year></pub-date><pub-date pub-type="epub"><day>19</day><month>5</month><year>2010</year></pub-date><volume>10</volume><issue>Suppl 1</issue><supplement><named-content content-type="supplement-title">de Senectute: Age and Health Forum</named-content><named-content content-type="supplement-editor">Stefano De Franciscis, Giammario Giustozzi, Raffaele Serra and Beatrice Sensi.</named-content><ext-link ext-link-type="uri" xlink:href="http://www.biomedcentral.com/content/pdf/1471-2318-10-S1-info.pdf">http://www.biomedcentral.com/content/pdf/1471-2318-10-S1-info.pdf</ext-link></supplement><fpage>A50</fpage><lpage>A50</lpage><permissions><copyright-statement>Copyright ©2010 Campisi et al; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2010</copyright-year><copyright-holder>Campisi et al; licensee BioMed Central Ltd.</copyright-holder></permissions><self-uri xlink:href="http://www.biomedcentral.com/1471-2318/10/S1/A50"></self-uri><abstract><sec><title></title></sec></abstract><conference><conf-date>5–7 December 2009</conf-date><conf-name>de Senectute: Age and Health Forum</conf-name><conf-loc>Catanzaro, Italy</conf-loc></conference></article-meta></front><body><sec><title>Background</title><p>Lymphedema, refractory to non-operative methods [<xref ref-type="bibr" rid="B1">1</xref>], may be managed by surgical treatment. Indications include insufficient lymphedema reduction by well performed medical and physical therapy (less than 50%), recurrent episodes of lymphangitis, intractable pain, worsening limb function, patient unsatisfied of the results obtained by non-operative methods and willing to proceed with surgical options. In this study Authors report a new lymphedema staging and their wide clinical experience in the microsurgical treatment of peripheral lymphedema [<xref ref-type="bibr" rid="B2">2</xref>,<xref ref-type="bibr" rid="B3">3</xref>] in geriatric age.</p></sec><sec sec-type="materials|methods"><title>Materials and methods</title><p>More than 500 patients with peripheral lymphedema in geriatrics have been treated with microsurgical techniques. Derivative lymphatic micro-vascular procedures recognize today its most exemplary application in multiple lymphatic-venous anastomoses (LVA). In the case of associated venous disease reconstructive lymphatic microsurgery techniques have been developed. Objective assessment was undertaken by water volumetry and lymphoscintigraphy. Lymphedema staging is reported in Table <xref ref-type="table" rid="T1">1</xref>.</p><table-wrap id="T1" position="float"><label>Table 1</label><table frame="hsides" rules="groups"><thead><tr><th>Stage I<break></break><bold>A.</bold><bold>"Latent" lymphedema</bold>, without clinical evidence of edema, but with impaired lymph transport capacity ( provable by lymphoscintigraphy) and with initial immuno-histochemical alterations of lymph nodes, lymph vessels and extracellular matrix.<break></break><bold>B.</bold><bold>“Initial” lymphedema</bold>, totally or partially decreasing by rest and draining position, with worsening impairment of lymph transport capacity and of immuno-histochemical alterations of lymph collectors, nodes and extracellular matrix.</th></tr></thead><tbody><tr><td><bold>Stage II</bold><break></break><bold>A. “Increasing” lymphedema</bold>, with vanishing lymph transport capacity, relapsing lymphangitic attacks, fibroindurative skin changes, and <bold>developing disability</bold>.<break></break><bold>B. "Column shaped" limb fibrolymphedema</bold>, with lymphostatic skin changes, suppressed lymph transport capacity and <bold>worsening disability.</bold></td></tr><tr><td colspan="1"><hr></hr></td></tr><tr><td><bold>Stage III</bold><break></break><bold>A. Properly called “elephantiasis”</bold>, with scleroindurative pachydermitis, papillomatous lymphostatic verrucosis, no lymph transport capacity and <bold>life-threatening disability</bold>.<break></break><bold>B. “Extreme elephantiasis”</bold> with <bold>total disability</bold>.</td></tr></tbody></table></table-wrap></sec><sec><title>Results</title><p>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 (Figure <xref ref-type="fig" rid="F1">1</xref>). Of those patients followed-up, 85% have been able to discontinue the use of conservative measures, with an average follow-up of more than 10 years and average reduction in excess volume of 69%. There was a 87% reduction in the incidence of cellulitis after microsurgery.</p><fig id="F1" position="float"><label>Figure 1</label><caption><p>Breast cancer related lymphedema before (A) and long term after (C) microsurgical lymphatic-venous anastomoses (B).</p></caption><graphic xlink:href="1471-2318-10-S1-A50-1"></graphic></fig></sec><sec><title>Conclusions</title><p>Microsurgical lymphatic-venous anastomoses have a place in the treatment of peripheral lymphedema in geriatrics especially in early stages, and should be the therapy of choice in patients who are not sufficiently responsive to nonsurgical treatment.</p></sec></body><back><ref-list><ref id="B1"><mixed-citation publication-type="journal"><name><surname>Dellachà</surname><given-names>A</given-names></name><name><surname>Boccardo</surname><given-names>F</given-names></name><name><surname>Zilli</surname><given-names>A</given-names></name><name><surname>Napoli</surname><given-names>F</given-names></name><name><surname>Fulcheri</surname><given-names>E</given-names></name><name><surname>Campisi</surname><given-names>C</given-names></name><article-title>Unexpected Histopathological Findings in Peripheral Lymphedema.</article-title><source>Lymphology</source><year>2000</year><volume>33</volume><fpage>62</fpage><lpage>64</lpage><pub-id pub-id-type="pmid">10897472</pub-id></mixed-citation></ref><ref id="B2"><mixed-citation publication-type="journal"><name><surname>Campisi</surname><given-names>C</given-names></name><name><surname>Boccardo</surname><given-names>F</given-names></name><article-title>Microsurgical techniques for lymphedema treatment: derivative lymphatic-venous microsurgery.</article-title><source>World J Surg</source><year>2004</year><volume>28</volume><issue>6</issue><fpage>609</fpage><lpage>13</lpage><pub-id pub-id-type="doi">10.1007/s00268-004-7252-4</pub-id><pub-id pub-id-type="pmid">15366754</pub-id></mixed-citation></ref><ref id="B3"><mixed-citation publication-type="journal"><name><surname>Campisi</surname><given-names>C</given-names></name><name><surname>Boccardo</surname><given-names>F</given-names></name><name><surname>Tacchella</surname><given-names>M</given-names></name><article-title>Reconstructive microsurgery of lymph vessels: The personal method of lymphatic-venous-lymphatic (LVL) interpositioned grafted shunt.</article-title><source>Microsurgery</source><year>1995</year><volume>16</volume><issue>3</issue><fpage>161</fpage><lpage>6</lpage><pub-id pub-id-type="doi">10.1002/micr.1920160309</pub-id><pub-id pub-id-type="pmid">7637625</pub-id></mixed-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001D72 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 001D72 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= LymphedemaV1
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:3290194
|texte= Lymphedema staging and surgical indications in geriatric age
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:NONE" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a LymphedemaV1
| This area was generated with Dilib version V0.6.31. |  |