LYMPHA Technique to Prevent Secondary Lower Limb Lymphedema

Francesco Boccardo, Mario Valenzano, Sergio Costantini, Federico Casabona, Matteo Morotti, Paolo Sala, Franco de Cian, Lidia Molinari, Stefano Spinaci, Sara Dessalvi, Corrado Cesare Campisi, Giuseppe Villa, Corradino Campisi

Research output: Contribution to journalArticle

Abstract

Background: Inguinofemoral lymphadenectomy carries a high risk of lower limb lymphedema. This report describes the feasibility of performing multiple lymphatic-venous anastomoses (MLVA) after inguinofemoral lymph node completion (LYMPHA technique) and the possible benefit of LYMPHA for preventing lymphedema. Methods: Between February, 2011 and October, 2014, 11 patients with vulvar cancer and 16 patients with melanoma of the trunk requiring inguinofemoral lymphadenectomy underwent lymph node dissection and the LYMPHA technique. Blue dye was injected into the thigh 10 min before surgery. Lymphatics afferent to the blue nodes were used to perform MLVA using a collateral branch of the great saphenous vein. Results: The mean age of patients in the vulvar cancer group was 52 years (range, 48–75 years). The melanoma group comprised seven men and nine women with a mean age of 41 years (range, 37–56 years). Of the 16 patients, 5 with vulvar cancer underwent bilateral inguinofemoral lymphadenectomy, whereas the remaining 6 patients with vulvar cancer and all 16 patients with melanoma of the trunk had unilateral node dissection. All the patients were treated by the LYMPHA technique. No lymphocele or infectious complications occurred. Transient lower-extremity edema occurred for one melanoma patient (6.25 %), which resolved after 2 months, and permanent lower-extremity edema occurred for one patient (9 %) with vulvar cancer. Conclusions: The LYMPHA technique appears to be feasible, safe, and effective for the prevention of lower limb lymphedema, thereby improving the patient’s quality of life and decreasing health care costs.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalAnnals of Surgical Oncology
DOIs
Publication statusAccepted/In press - May 24 2016

Fingerprint

Lymphedema
Lower Extremity
Vulvar Neoplasms
Lymph Node Excision
Melanoma
Edema
Lymphocele
Saphenous Vein
Thigh
Health Care Costs
Dissection
Coloring Agents
Lymph Nodes
Quality of Life

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Boccardo, F., Valenzano, M., Costantini, S., Casabona, F., Morotti, M., Sala, P., ... Campisi, C. (Accepted/In press). LYMPHA Technique to Prevent Secondary Lower Limb Lymphedema. Annals of Surgical Oncology, 1-6. https://doi.org/10.1245/s10434-016-5282-4

LYMPHA Technique to Prevent Secondary Lower Limb Lymphedema. / Boccardo, Francesco; Valenzano, Mario; Costantini, Sergio; Casabona, Federico; Morotti, Matteo; Sala, Paolo; de Cian, Franco; Molinari, Lidia; Spinaci, Stefano; Dessalvi, Sara; Campisi, Corrado Cesare; Villa, Giuseppe; Campisi, Corradino.

In: Annals of Surgical Oncology, 24.05.2016, p. 1-6.

Research output: Contribution to journalArticle

Boccardo, F, Valenzano, M, Costantini, S, Casabona, F, Morotti, M, Sala, P, de Cian, F, Molinari, L, Spinaci, S, Dessalvi, S, Campisi, CC, Villa, G & Campisi, C 2016, 'LYMPHA Technique to Prevent Secondary Lower Limb Lymphedema', Annals of Surgical Oncology, pp. 1-6. https://doi.org/10.1245/s10434-016-5282-4
Boccardo F, Valenzano M, Costantini S, Casabona F, Morotti M, Sala P et al. LYMPHA Technique to Prevent Secondary Lower Limb Lymphedema. Annals of Surgical Oncology. 2016 May 24;1-6. https://doi.org/10.1245/s10434-016-5282-4
Boccardo, Francesco ; Valenzano, Mario ; Costantini, Sergio ; Casabona, Federico ; Morotti, Matteo ; Sala, Paolo ; de Cian, Franco ; Molinari, Lidia ; Spinaci, Stefano ; Dessalvi, Sara ; Campisi, Corrado Cesare ; Villa, Giuseppe ; Campisi, Corradino. / LYMPHA Technique to Prevent Secondary Lower Limb Lymphedema. In: Annals of Surgical Oncology. 2016 ; pp. 1-6.
@article{68cb3d4da365428d8f6e334f1d86f8d2,
title = "LYMPHA Technique to Prevent Secondary Lower Limb Lymphedema",
abstract = "Background: Inguinofemoral lymphadenectomy carries a high risk of lower limb lymphedema. This report describes the feasibility of performing multiple lymphatic-venous anastomoses (MLVA) after inguinofemoral lymph node completion (LYMPHA technique) and the possible benefit of LYMPHA for preventing lymphedema. Methods: Between February, 2011 and October, 2014, 11 patients with vulvar cancer and 16 patients with melanoma of the trunk requiring inguinofemoral lymphadenectomy underwent lymph node dissection and the LYMPHA technique. Blue dye was injected into the thigh 10 min before surgery. Lymphatics afferent to the blue nodes were used to perform MLVA using a collateral branch of the great saphenous vein. Results: The mean age of patients in the vulvar cancer group was 52 years (range, 48–75 years). The melanoma group comprised seven men and nine women with a mean age of 41 years (range, 37–56 years). Of the 16 patients, 5 with vulvar cancer underwent bilateral inguinofemoral lymphadenectomy, whereas the remaining 6 patients with vulvar cancer and all 16 patients with melanoma of the trunk had unilateral node dissection. All the patients were treated by the LYMPHA technique. No lymphocele or infectious complications occurred. Transient lower-extremity edema occurred for one melanoma patient (6.25 {\%}), which resolved after 2 months, and permanent lower-extremity edema occurred for one patient (9 {\%}) with vulvar cancer. Conclusions: The LYMPHA technique appears to be feasible, safe, and effective for the prevention of lower limb lymphedema, thereby improving the patient’s quality of life and decreasing health care costs.",
author = "Francesco Boccardo and Mario Valenzano and Sergio Costantini and Federico Casabona and Matteo Morotti and Paolo Sala and {de Cian}, Franco and Lidia Molinari and Stefano Spinaci and Sara Dessalvi and Campisi, {Corrado Cesare} and Giuseppe Villa and Corradino Campisi",
year = "2016",
month = "5",
day = "24",
doi = "10.1245/s10434-016-5282-4",
language = "English",
pages = "1--6",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York LLC",

}

TY - JOUR

T1 - LYMPHA Technique to Prevent Secondary Lower Limb Lymphedema

AU - Boccardo, Francesco

AU - Valenzano, Mario

AU - Costantini, Sergio

AU - Casabona, Federico

AU - Morotti, Matteo

AU - Sala, Paolo

AU - de Cian, Franco

AU - Molinari, Lidia

AU - Spinaci, Stefano

AU - Dessalvi, Sara

AU - Campisi, Corrado Cesare

AU - Villa, Giuseppe

AU - Campisi, Corradino

PY - 2016/5/24

Y1 - 2016/5/24

N2 - Background: Inguinofemoral lymphadenectomy carries a high risk of lower limb lymphedema. This report describes the feasibility of performing multiple lymphatic-venous anastomoses (MLVA) after inguinofemoral lymph node completion (LYMPHA technique) and the possible benefit of LYMPHA for preventing lymphedema. Methods: Between February, 2011 and October, 2014, 11 patients with vulvar cancer and 16 patients with melanoma of the trunk requiring inguinofemoral lymphadenectomy underwent lymph node dissection and the LYMPHA technique. Blue dye was injected into the thigh 10 min before surgery. Lymphatics afferent to the blue nodes were used to perform MLVA using a collateral branch of the great saphenous vein. Results: The mean age of patients in the vulvar cancer group was 52 years (range, 48–75 years). The melanoma group comprised seven men and nine women with a mean age of 41 years (range, 37–56 years). Of the 16 patients, 5 with vulvar cancer underwent bilateral inguinofemoral lymphadenectomy, whereas the remaining 6 patients with vulvar cancer and all 16 patients with melanoma of the trunk had unilateral node dissection. All the patients were treated by the LYMPHA technique. No lymphocele or infectious complications occurred. Transient lower-extremity edema occurred for one melanoma patient (6.25 %), which resolved after 2 months, and permanent lower-extremity edema occurred for one patient (9 %) with vulvar cancer. Conclusions: The LYMPHA technique appears to be feasible, safe, and effective for the prevention of lower limb lymphedema, thereby improving the patient’s quality of life and decreasing health care costs.

AB - Background: Inguinofemoral lymphadenectomy carries a high risk of lower limb lymphedema. This report describes the feasibility of performing multiple lymphatic-venous anastomoses (MLVA) after inguinofemoral lymph node completion (LYMPHA technique) and the possible benefit of LYMPHA for preventing lymphedema. Methods: Between February, 2011 and October, 2014, 11 patients with vulvar cancer and 16 patients with melanoma of the trunk requiring inguinofemoral lymphadenectomy underwent lymph node dissection and the LYMPHA technique. Blue dye was injected into the thigh 10 min before surgery. Lymphatics afferent to the blue nodes were used to perform MLVA using a collateral branch of the great saphenous vein. Results: The mean age of patients in the vulvar cancer group was 52 years (range, 48–75 years). The melanoma group comprised seven men and nine women with a mean age of 41 years (range, 37–56 years). Of the 16 patients, 5 with vulvar cancer underwent bilateral inguinofemoral lymphadenectomy, whereas the remaining 6 patients with vulvar cancer and all 16 patients with melanoma of the trunk had unilateral node dissection. All the patients were treated by the LYMPHA technique. No lymphocele or infectious complications occurred. Transient lower-extremity edema occurred for one melanoma patient (6.25 %), which resolved after 2 months, and permanent lower-extremity edema occurred for one patient (9 %) with vulvar cancer. Conclusions: The LYMPHA technique appears to be feasible, safe, and effective for the prevention of lower limb lymphedema, thereby improving the patient’s quality of life and decreasing health care costs.

UR - http://www.scopus.com/inward/record.url?scp=84976620128&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84976620128&partnerID=8YFLogxK

U2 - 10.1245/s10434-016-5282-4

DO - 10.1245/s10434-016-5282-4

M3 - Article

AN - SCOPUS:84976620128

SP - 1

EP - 6

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

ER -