Surgical Management of Lower Extremity Lymphedema: A Comprehensive Review
Lymphedema refers to the accumulation of protein-rich fluid in the interstitial spaces. This can occur secondary to congenital malformation of the lymphatic channels or nodes or as a result of an insult that damages appropriately formed channels and nodes. Stagnant, protein-rich lymph initiates an i...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2019-01-01
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| Series: | Indian Journal of Plastic Surgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1688537 |
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| author | Pedro Ciudad M. Diya Sabbagh Mouchammed Agko Tony C.T. Huang Oscar J. Manrique Carmen Román L. Cesar Reynaga Ricardo Delgado Michele Maruccia Hung-Chi Chen |
| author_facet | Pedro Ciudad M. Diya Sabbagh Mouchammed Agko Tony C.T. Huang Oscar J. Manrique Carmen Román L. Cesar Reynaga Ricardo Delgado Michele Maruccia Hung-Chi Chen |
| author_sort | Pedro Ciudad |
| collection | DOAJ |
| description | Lymphedema refers to the accumulation of protein-rich fluid in the interstitial spaces. This can occur secondary to congenital malformation of the lymphatic channels or nodes or as a result of an insult that damages appropriately formed channels and nodes. Stagnant, protein-rich lymph initiates an inflammatory response that leads to adipocyte proliferation, fibrous tissue deposition, and increased susceptibility to infections. The end result is permanent disfigurement and dermal changes. Early and accurate diagnosis is essential, since lymphedema is a chronic and progressive problem. When lymphedema affects the lower extremity, it is important to manage it in a way that preserves function and mobility. Early diagnosis also allows for a proactive rather than reactive approach to treatment and utilization of novel physiologic procedures, such as lymphovenous anastomosis and vascularized lymph node transfer. Such interventions slow down disease progression and reduce morbidity by allowing the surgeon to salvage the remaining functional lymphatic channels. When physiologic procedures fail or when faced with a delayed presentation, the addition of excisional procedures can provide a more comprehensive treatment of this debilitating disease. The aim of this article is to review the most current concepts in the surgical management of lower extremity lymphedema. |
| format | Article |
| id | doaj-art-05ecc0555f654e209e7829433a145994 |
| institution | OA Journals |
| issn | 0970-0358 1998-376X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Plastic Surgery |
| spelling | doaj-art-05ecc0555f654e209e7829433a1459942025-08-20T02:03:42ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2019-01-01520108109210.1055/s-0039-1688537Surgical Management of Lower Extremity Lymphedema: A Comprehensive ReviewPedro Ciudad0M. Diya Sabbagh1Mouchammed Agko2Tony C.T. Huang3Oscar J. Manrique4Carmen Román L.5Cesar Reynaga6Ricardo Delgado7Michele Maruccia8Hung-Chi Chen9Department of Plastic, Reconstructive and Burn Surgery, Arzobispo Loayza National Hospital, Lima, PeruDivision of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota, United SatesSection of Plastic Surgery, Medical College of Georgia, Augusta University, Augusta, GeorgiaDivision of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota, United SatesDivision of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota, United SatesDepartment of Physical and Rehabilitation Medicine, National Cancer Institute of Peru (INEN), Lima, PeruDepartment of Plastic, Reconstructive and Burn Surgery, Arzobispo Loayza National Hospital, Lima, PeruDepartment of Plastic and Reconstructive Surgery, National Cancer Institute of Peru (INEN), Lima, PeruDepartment of Plastic, Reconstructive and Burn Surgery, Arzobispo Loayza National Hospital, Lima, PeruDepartment of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, TaiwanLymphedema refers to the accumulation of protein-rich fluid in the interstitial spaces. This can occur secondary to congenital malformation of the lymphatic channels or nodes or as a result of an insult that damages appropriately formed channels and nodes. Stagnant, protein-rich lymph initiates an inflammatory response that leads to adipocyte proliferation, fibrous tissue deposition, and increased susceptibility to infections. The end result is permanent disfigurement and dermal changes. Early and accurate diagnosis is essential, since lymphedema is a chronic and progressive problem. When lymphedema affects the lower extremity, it is important to manage it in a way that preserves function and mobility. Early diagnosis also allows for a proactive rather than reactive approach to treatment and utilization of novel physiologic procedures, such as lymphovenous anastomosis and vascularized lymph node transfer. Such interventions slow down disease progression and reduce morbidity by allowing the surgeon to salvage the remaining functional lymphatic channels. When physiologic procedures fail or when faced with a delayed presentation, the addition of excisional procedures can provide a more comprehensive treatment of this debilitating disease. The aim of this article is to review the most current concepts in the surgical management of lower extremity lymphedema.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1688537lymphedemavascularized lymph node transferradical reduction in lymphedema with preservation of perforatorssuction-assisted lipectomylower extremity lymphedema |
| spellingShingle | Pedro Ciudad M. Diya Sabbagh Mouchammed Agko Tony C.T. Huang Oscar J. Manrique Carmen Román L. Cesar Reynaga Ricardo Delgado Michele Maruccia Hung-Chi Chen Surgical Management of Lower Extremity Lymphedema: A Comprehensive Review Indian Journal of Plastic Surgery lymphedema vascularized lymph node transfer radical reduction in lymphedema with preservation of perforators suction-assisted lipectomy lower extremity lymphedema |
| title | Surgical Management of Lower Extremity Lymphedema: A Comprehensive Review |
| title_full | Surgical Management of Lower Extremity Lymphedema: A Comprehensive Review |
| title_fullStr | Surgical Management of Lower Extremity Lymphedema: A Comprehensive Review |
| title_full_unstemmed | Surgical Management of Lower Extremity Lymphedema: A Comprehensive Review |
| title_short | Surgical Management of Lower Extremity Lymphedema: A Comprehensive Review |
| title_sort | surgical management of lower extremity lymphedema a comprehensive review |
| topic | lymphedema vascularized lymph node transfer radical reduction in lymphedema with preservation of perforators suction-assisted lipectomy lower extremity lymphedema |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1688537 |
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