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Missouri Medicine 2021The purpose of this article is to describe the multidisciplinary lymphedema surgery treatment program at Washington University in St. Louis. In this article, we discuss...
The purpose of this article is to describe the multidisciplinary lymphedema surgery treatment program at Washington University in St. Louis. In this article, we discuss our collaboration with colleagues in medicine and therapy for conservative management and lymphedema staging. We describe our preferred imaging modalities for diagnosis, staging, and surgical treatment. Finally, we provide an overview of the surgical procedures we perform and our surgical treatment algorithm.
Topics: Humans; Lymphedema
PubMed: 33840856
DOI: No ID Found -
Mayo Clinic Proceedings Nov 2005Every year in the United States, breast cancer is diagnosed in more than 200,000 women. Because of the prevalence of breast cancer, treatment-related sequelae are of... (Review)
Review
Every year in the United States, breast cancer is diagnosed in more than 200,000 women. Because of the prevalence of breast cancer, treatment-related sequelae are of Importance to many survivors of the disease. One such sequela is upper extremity lymphedema, which occurs when fluid accumulates in the Interstitial space and causes enlargement and usually a feeling of heaviness in the limb. Axillary surgery contributes considerably to the incidence of lymphedema, with the incidence and severity of swelling related to the number of lymph nodes removed. Lymphedema after standard axillary lymph node dissection can occur in up to approximately 50% of patients. However, the risk of lymphedema is decreased substantially with newer sentinel lymph node sampling procedures. Adjuvant radiotherapy to the breast or lymph nodes increases the risk of lymphedema, which has been reported in 9% to 40% of these patients. Management of lymphedema requires a multidisciplinary approach to minimize the effect on the patient's quality of life. This review presents an overview of the pathophysiology, diagnosis, prevention, and treatment of breast cancer-related lymphedema.
Topics: Breast Neoplasms; Female; Humans; Lymphedema
PubMed: 16295027
DOI: 10.4065/80.11.1480 -
Dermatologic Therapy 2012The basic principle of the management of lymphedema is so called complex decongestive physical therapy. This therapy is divided into two phases: (i) edema reduction...
The basic principle of the management of lymphedema is so called complex decongestive physical therapy. This therapy is divided into two phases: (i) edema reduction phase--an initial intensive treatment phase aiming for limb volume reduction; and (ii) maintenance phase--following long-term phase to sustain a manageable limb volume. The first phase consists of a number of physical therapeutic approaches which are: manual lymph drainage, pneumatic pump drainage, low-stretch bandaging, exercises, and skin care. Long-term maintenance phase consists of self-lymph drainage, low-stretch bandaging, or compressive garments, and sometimes when indicated pneumatic pump drainage, exercises, and skin care.
Topics: Compression Bandages; Exercise Therapy; Humans; Intermittent Pneumatic Compression Devices; Lymphedema; Massage; Quality of Life; Skin Cream
PubMed: 22950562
DOI: 10.1111/j.1529-8019.2012.01534.x -
Circulation Mar 2011
Review
Topics: Animals; Humans; Lymphangiogenesis; Lymphatic System; Lymphatic Vessels; Lymphedema
PubMed: 21444892
DOI: 10.1161/CIRCULATIONAHA.107.704098 -
Journal of Medical Genetics Jun 1965
Topics: Blood Group Antigens; Child; Genetics, Medical; Humans; Lymphedema
PubMed: 14295660
DOI: 10.1136/jmg.2.2.93 -
Seminars in Cell & Developmental Biology Feb 2015While our understanding of the lymphatic system has improved substantially in the past few decades, the translation of this knowledge into improved healthcare solutions... (Review)
Review
While our understanding of the lymphatic system has improved substantially in the past few decades, the translation of this knowledge into improved healthcare solutions for patients suffering from secondary lymphedema has been severely limited. The challenge facing clinicians is two-fold. First, there is no reliable, affordable, diagnostic capable of detecting the disease before symptoms of the lymphedema develop and the efficacy of treatment options becomes limited. Second, our understanding of the disease pathogenesis, its risk factors, and the underlying physiologic mechanisms is still in its infancy. These two challenges go hand in hand as limited diagnostic options have hindered our ability to understand lymphedema progression, and the lack of known underlying mechanisms involved in the disease prohibits the development of new diagnostic targets. This review serves to discuss the recent developments in clinical and lab research settings of both lymphedema diagnostic technologies and our understanding of the mechanisms driving disease risk and progression. We will show how these two lines of research are synergistically working with the ultimate goal of improving patient outcomes for those suffering from this horrible disease, identifying key areas of further research that are warranted to move the field forward and provide clinical relief for this neglected patient population.
Topics: Animals; Fluorescence; Humans; Infrared Rays; Lymphatic Vessels; Lymphedema; Magnetic Resonance Angiography; Neoplasms
PubMed: 25545813
DOI: 10.1016/j.semcdb.2014.12.003 -
European Journal of Dermatology : EJD 2009An 8-year-old girl referred to our Department for a two-month worsening of congenital primary lymphedema of the lower limb and for the appearance of several purpuric...
An 8-year-old girl referred to our Department for a two-month worsening of congenital primary lymphedema of the lower limb and for the appearance of several purpuric lesions on the right thigh and knee. We diagnosed a lichenoid pigmented purpura of Gougerot and Blum in a patient with Milroy disease, complicated by an insufficiency of anterior saphena. We treated the patient with topical steroids and compression stockings, until surgical intervention of phlebectomy. We report this case for the rarity of the disease, for the even more rare association with lichenoid pigmented purpura and for cutaneous immunopathological findings.
Topics: Child; Diagnosis, Differential; Female; Glucocorticoids; Humans; Knee; Lymphedema; Purpura; Saphenous Vein; Skin Diseases, Papulosquamous; Stockings, Compression; Syndactyly; Syndrome; Thigh; Toes; Treatment Outcome
PubMed: 19620038
DOI: 10.1684/ejd.2009.0758 -
Journal of Surgical Oncology Jan 2017Lymphedema is a common morbid after cancer treatment. The disease characterizes with progressive inflammatory process that result in irreversible fibrosis. Its... (Review)
Review
Lymphedema is a common morbid after cancer treatment. The disease characterizes with progressive inflammatory process that result in irreversible fibrosis. Its chronology and progressive disease character often impacts the quality of life of cancer survivors. The pathophysiology of lymphedema remains unclear and the disease remains non-curable. In this article, we reviewed available studies of lymphedema and concluded possible treatment strategies for lymphedema. J. Surg. Oncol. 2017;115:96-98. © 2016 Wiley Periodicals, Inc.
Topics: Animals; Humans; Lymphedema
PubMed: 27566412
DOI: 10.1002/jso.24414 -
British Journal of Nursing (Mark Allen...Lymphoedema in children is rare and poorly recognized. Children with lymphoedema have great difficulty accessing appropriate services and treatment. The long term global... (Review)
Review
Lymphoedema in children is rare and poorly recognized. Children with lymphoedema have great difficulty accessing appropriate services and treatment. The long term global consequences of living with this incurable condition are under-estimated. This article outlines the causes, effects and treatment of lymphoedema in children. Recommendations are made that all children with lymphoedema should be referred to a lymphoedema specialist as soon as swelling develops.
Topics: Child; Chronic Disease; Humans; Lymphedema; Pediatric Nursing
PubMed: 20505601
DOI: 10.12968/bjon.2010.19.7.47437 -
Revue de Pneumologie Clinique Oct 2013Lymphedema associated with other developmental malformations (Milroy syndrome, Hennekam syndrome, Noonan syndrome, Gorham-Stout syndrome, yellow nail syndrome) are... (Review)
Review
Lymphedema associated with other developmental malformations (Milroy syndrome, Hennekam syndrome, Noonan syndrome, Gorham-Stout syndrome, yellow nail syndrome) are unfrequent disease, but explorations led to the identification of genetic mutations that have then been validated in mouse models. However, lymphatic vessels complexity and its proximity with the venous system suggest the need for further researches, especially in the comprehension of pulmonary symptoms.
Topics: Animals; Craniofacial Abnormalities; Eyelashes; Genital Diseases, Male; Humans; Lung Diseases; Lymphangiectasis, Intestinal; Lymphatic Diseases; Lymphedema; Mice; Noonan Syndrome; Osteolysis, Essential; Yellow Nail Syndrome
PubMed: 23561737
DOI: 10.1016/j.pneumo.2013.02.001