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Seminars in Oncology Nursing Feb 2013To summarize the evidence of and identify factors influencing the psychosocial impact of lymphedema, as well as to discuss nursing strategies. (Review)
Review
OBJECTIVES
To summarize the evidence of and identify factors influencing the psychosocial impact of lymphedema, as well as to discuss nursing strategies.
DATA SOURCES
Peer-reviewed publications from 2004 to 2011 in 11 major medical indices.
CONCLUSION
Poorer overall health-related quality of life was reported among cancer survivors with lymphedema. The consistent, detailed, and vivid descriptions from the qualitative studies suggest that cancer-related lymphedema exerts tremendous negative psychosocial impact, which quantitative studies failed to capture.
IMPLICATIONS FOR NURSING PRACTICE
Nursing strategies include helping patients to build a routine for daily care, setting goals, exercise, positive self-talk, providing helpful resources, and organizing support groups. Professional organizations should devote resources to public education through television advertisement, public meetings, and online education.
Topics: Humans; Lymphedema; Neoplasms; Quality of Life
PubMed: 23375066
DOI: 10.1016/j.soncn.2012.11.007 -
Cancer Practice 1997The author discusses the lymphatic circulatory system and the pathogenesis, risk and protective factors, complications, and treatment of lymphedema. Quality-of-life... (Review)
Review
PURPOSE
The author discusses the lymphatic circulatory system and the pathogenesis, risk and protective factors, complications, and treatment of lymphedema. Quality-of-life issues, educational needs of patients and families, and suggestions for future research also are addressed.
OVERVIEW
Chronic lymphedema of the arm after axillary lymph node dissection is a potential sequela of breast cancer treatment that has a profound impact on quality of life. Lymphedema may occur any time during the patient's life triggered by even minor trauma, with subsequent inflammation of the affected arm. Treatment of lymphedema may be uncomfortable and unsuccessful. Physical and psychological well-being can be affected negatively by the illness or its treatment.
CLINICAL IMPLICATIONS
All healthcare professionals coming in contact with individuals having an axillary lymph node dissection need to be aware that the risk of lymphedema is life-long. Specific measures to prevent trauma to the affected arm are noted.
Topics: Humans; Incidence; Lymphedema; Primary Prevention; Quality of Life; Risk Factors
PubMed: 9128494
DOI: No ID Found -
Journal of Veterinary Internal Medicine 1992Medical management of lymphedema is warranted in all dogs with suspected congenital lymphedema, before surgical intervention. Although pharmaceutical agents, such as the... (Review)
Review
Medical management of lymphedema is warranted in all dogs with suspected congenital lymphedema, before surgical intervention. Although pharmaceutical agents, such as the benzo-pyrones, have not been investigated for clinical use in dogs, such studies appear to be justified. None of the surgical techniques discussed will cure lymphedema. The only technique reported with any frequency in the dog has been excision of affected tissues, and although some successes have been reported with this procedure, others have found it to be of no benefit or severe complications have occurred. Excisional techniques require meticulous attention to prevent infection intraoperatively and postoperatively. Staging the procedure may decrease problems associated with devascularization of remaining tissues. Evaluation of other techniques may be warranted in dogs; however, no technique has proven to be consistently beneficial in human beings with lymphedema.
Topics: Animals; Dog Diseases; Dogs; Lymphedema; Lymphography
PubMed: 1484372
DOI: 10.1111/j.1939-1676.1992.tb00361.x -
International Journal of Clinical... Oct 2005Although lymphedema in the extremities is a troublesome adverse effect following radical resection of various cancers, conventional therapies for lymphedema are not... (Review)
Review
Although lymphedema in the extremities is a troublesome adverse effect following radical resection of various cancers, conventional therapies for lymphedema are not always satisfactory, and new breakthroughs are anticipated. With the introduction of supermicrosurgical techniques for the anastomosis of blood or lymphatic vessels less than 0.8 mm in diameter, we have developed a novel method of lymphaticovenular anastomosis for the treatment of primary as well as secondary lymphedema in the extremities. Here, we review the pathophysiological aspects of lymphedema, emphasizing the importance of smooth-muscle cell function in the affected lymphatic walls. We then describe the theoretical basis and detailed operative techniques of our lymphaticovenular anastomoses. Although technically demanding, especially for beginners, we believe that this method will become a new clinical standard for the treatment of lymphedema in the near future.
Topics: Anastomosis, Surgical; Humans; Leg; Lymphatic Vessels; Lymphedema; Microsurgery
PubMed: 16247656
DOI: 10.1007/s10147-005-0518-5 -
Annals of Plastic Surgery Oct 2007Lymphedema is a chronic, debilitating condition that has traditionally been seen as refractory or incurable. Recent years have brought new advances in the study of... (Review)
Review
BACKGROUND
Lymphedema is a chronic, debilitating condition that has traditionally been seen as refractory or incurable. Recent years have brought new advances in the study of lymphedema pathophysiology, as well as diagnostic and therapeutic tools that are changing this perspective.
OBJECTIVE
To provide a systematic approach to evaluating and managing patients with lymphedema.
METHODS
We performed MEDLINE searches of the English-language literature (1966 to March 2006) using the terms lymphedema, breast cancer-associated lymphedema, lymphatic complications, lymphatic imaging, decongestive therapy, and surgical treatment of lymphedema. Relevant bibliographies and International Society of Lymphology guidelines were also reviewed.
RESULTS
In the United States, the populations primarily affected by lymphedema are patients undergoing treatment of malignancy, particularly women treated for breast cancer. A thorough evaluation of patients presenting with extremity swelling should include identification of prior surgical or radiation therapy for malignancy, as well as documentation of other risk factors for lymphedema, such as prior trauma to or infection of the affected limb. Physical examination should focus on differentiating signs of lymphedema from other causes of systemic or localized swelling. Lymphatic dysfunction can be visualized through lymphoscintigraphy; the diagnosis of lymphedema can also be confirmed through other imaging modalities, including CT or MRI. The mainstay of therapy in diagnosed cases of lymphedema involves compression garment use, as well as intensive bandaging and lymphatic massage. For patients who are unresponsive to conservative therapy, several surgical options with varied proven efficacies have been used in appropriate candidates, including excisional approaches, microsurgical lymphatic anastomoses, and circumferential suction-assisted lipectomy, an approach that has shown promise for long-term relief of symptoms.
CONCLUSIONS
The diagnosis of lymphedema requires careful attention to patient risk factors and specific findings on physical examination. Noninvasive diagnostic tools and lymphatic imaging can be helpful to confirm the diagnosis of lymphedema or to address a challenging clinical presentation. Initial treatment with decongestive lymphatic therapy can provide significant improvement in patient symptoms and volume reduction of edematous extremities. Selected patients who are unresponsive to conservative therapy can achieve similar outcomes with surgical intervention, most promisingly suction-assisted lipectomy.
Topics: Breast Neoplasms; Humans; Lymphatic System; Lymphedema; Lymphoscintigraphy; Postoperative Complications; Risk Factors
PubMed: 17901744
DOI: 10.1097/01.sap.0000257149.42922.7e -
Casopis Lekaru Ceskych Sep 1987
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Indian Pediatrics Jan 1983
Topics: Humans; Infant; Lymphedema; Male
PubMed: 6862605
DOI: No ID Found -
Journal of Plastic, Reconstructive &... Mar 2023
Topics: Humans; Buttocks; Lymphedema
PubMed: 36822103
DOI: 10.1016/j.bjps.2023.01.006 -
Radiology Feb 1964
Topics: Humans; Lymphedema; Pleural Effusion; Radiography, Thoracic; Surgical Procedures, Operative
PubMed: 14115303
DOI: 10.1148/82.2.246 -
Clinics in Dermatology 1995
Review
Topics: Bandages; Diagnosis, Differential; Humans; Lymphedema; Physical Therapy Modalities; Skin Diseases
PubMed: 8665461
DOI: 10.1016/0738-081x(95)00095-w