-
Lymphatic Research and Biology Dec 2023
Topics: Humans; Epigenesis, Genetic; Lymphedema
PubMed: 38149918
DOI: 10.1089/lrb.2023.29155.editorial -
British Journal of Hospital Medicine... Oct 2023Supermicrosurgery was popularised in 1997 and is defined as a technique of microvascular anastomosis for single nerve fascicles and vessels 0.3-0.8 mm in diameter. It... (Review)
Review
Supermicrosurgery was popularised in 1997 and is defined as a technique of microvascular anastomosis for single nerve fascicles and vessels 0.3-0.8 mm in diameter. It requires the use of powerful microscopes, ultradelicate microsurgical instruments and specialist dyes. The development of supermicrosurgery has vastly improved the ability of microsurgeons to create true perforator flaps with minimal donor site morbidity for reconstructive surgery and improved the precision of additional microsurgical techniques. This review outlines the origins and history of supermicrosurgery, its current applications in reconstructive surgery (including fingertip reconstructions, true perforator flap surgery, nerve flaps and lymphoedema surgery), supermicrosurgery training and future directions for the field.
Topics: Humans; Plastic Surgery Procedures; Surgical Flaps; Anastomosis, Surgical; Lymphedema
PubMed: 37906072
DOI: 10.12968/hmed.2022.0482 -
Dermatologie (Heidelberg, Germany) Aug 2023Obesity causes all types of lymphedema to deteriorate. Obesity-associated lymphedema is by now the most frequent secondary lymphedema and constitutes an entity in its... (Review)
Review
Obesity causes all types of lymphedema to deteriorate. Obesity-associated lymphedema is by now the most frequent secondary lymphedema and constitutes an entity in its own right. Obesity and its comorbidities, due to mechanical and inflammatory effects, decrease lymphatic transport and create a vicious circle of lymph stasis, local adipogenesis, and fibrosis. The therapeutic strategy must therefore address both lymphedema and obesity and its comorbidities.
Topics: Humans; Lymphedema; Obesity; Lymph; Lymphatic Vessels; Fibrosis; Chronic Disease
PubMed: 37382603
DOI: 10.1007/s00105-023-05180-z -
Plastic and Reconstructive Surgery Dec 2023After studying this article, the participant should be able to: 1. Describe current surgical techniques for treating primary and secondary lymphedema. 2. Optimize the...
LEARNING OBJECTIVES
After studying this article, the participant should be able to: 1. Describe current surgical techniques for treating primary and secondary lymphedema. 2. Optimize the surgical care of patients with lymphedema.
SUMMARY
Over the past decade, significant advances have been made in the surgical treatment of lymphedema. The most notable changes have been the reintroduction and evolution of physiologic techniques, including lymphovenous bypass-sometimes referred to as lymphovenous anastomosis in the literature-and vascularized lymph node transplant. These surgical modalities are now often used as first-line surgical options or may be combined with nonphysiologic approaches, including direct excision and suction-assisted lipectomy. Surgeons continue to debate the most appropriate sequence and combination of surgical treatment, particularly for patients at both extremes of the severity spectrum. Furthermore, debate remains around the need to apply different treatment approaches for patients with upper versus lower extremity involvement and primary versus secondary cause. In this article, we provide a summary of the surgical techniques currently used for both primary and secondary lymphedema and provide our recommendations for optimizing the surgical care of patients with lymphedema.
Topics: Humans; Lymphedema; Lymphatic System; Lower Extremity; Vascular Surgical Procedures; Lymph Nodes; Anastomosis, Surgical
PubMed: 38019691
DOI: 10.1097/PRS.0000000000010965 -
Lymphatic Research and Biology Feb 2024
Topics: Humans; Lipedema; Lymphedema; Quality of Life
PubMed: 38394088
DOI: 10.1089/lrb.2024.29158.editorial -
Medicina (Kaunas, Lithuania) Nov 2023Lymphedema is a progressive condition. Its therapy aims to reduce edema, prevent its progression, and provide psychosocial aid. Nonsurgical treatment in advanced stages... (Review)
Review
Lymphedema is a progressive condition. Its therapy aims to reduce edema, prevent its progression, and provide psychosocial aid. Nonsurgical treatment in advanced stages is mostly insufficient. Therefore-in many cases-surgical procedures, such as to restore lymph flow or excise lymphedema tissues, are the only ways to improve patients' quality of life. Lymphoscintigraphy (LS), near-infrared fluorescent (NIRF) imaging-also termed indocyanine green (ICG) lymphography (ICG-L)-ultrasonography (US), magnetic resonance lymphangiography (MRL), computed tomography (CT), photoacoustic imaging (PAI), and optical coherence tomography (OCT) are standardized techniques, which can be utilized in lymphedema diagnosis, staging, treatment, and follow-up. The combined use of these imaging modalities and self-assessment questionnaires deliver objective parameters for choosing the most suitable surgical therapy and achieving the best possible postoperative outcome.
Topics: Humans; Quality of Life; Indocyanine Green; Coloring Agents; Lymphedema; Lymphography
PubMed: 38004065
DOI: 10.3390/medicina59112016 -
Nature Communications Dec 2023Lymphangiogenesis refers to the generation of new lymphatic vessels from pre-existing ones. During development and particular adult states, lymphatic endothelial cells... (Review)
Review
Lymphangiogenesis refers to the generation of new lymphatic vessels from pre-existing ones. During development and particular adult states, lymphatic endothelial cells (LEC) undergo reprogramming of their transcriptomic and signaling networks to support the high demands imposed by cell proliferation and migration. Although there has been substantial progress in identifying growth factors and signaling pathways controlling lymphangiogenesis in the last decades, insights into the role of metabolism in lymphatic cell functions are just emerging. Despite numerous similarities between the main metabolic pathways existing in LECs, blood ECs (BEC) and other cell types, accumulating evidence has revealed that LECs acquire a unique metabolic signature during lymphangiogenesis, and their metabolic engine is intertwined with molecular regulatory networks, resulting in a tightly regulated and interconnected process. Considering the implication of lymphatic dysfunction in cancer and lymphedema, alongside other pathologies, recent findings hold promising opportunities to develop novel therapeutic approaches. In this review, we provide an overview of the status of knowledge in the molecular and metabolic network regulating the lymphatic vasculature in health and disease.
Topics: Humans; Endothelial Cells; Lymphatic Vessels; Lymphangiogenesis; Lymphedema; Signal Transduction
PubMed: 38104163
DOI: 10.1038/s41467-023-44133-x -
The British Journal of Dermatology Dec 2023
Topics: Humans; Elephantiasis, Filarial; Self Care; Integrative Medicine; Lymphedema
PubMed: 38124524
DOI: 10.1093/bjd/ljad461 -
Journal de Medecine Vasculaire 2023
Topics: Humans; Lymphedema; Skin Neoplasms
PubMed: 38035920
DOI: 10.1016/j.jdmv.2023.10.008 -
Lymphatic Research and Biology Oct 2023
Topics: Humans; Lipedema; Lymphedema; Ultrasonography
PubMed: 37870782
DOI: 10.1089/lrb.2023.29151.editorial