TY - JOUR
T1 - Lymphatic microsurgery to treat lymphedema
T2 - Techniques and indications for better results
AU - Boccardo, Francesco
AU - Fulcheri, Ezio
AU - Villa, Giuseppe
AU - Molinari, Lidia
AU - Campisi, Corrado
AU - Dessalvi, Sara
AU - Murdaca, Giuseppe
AU - Campisi, Caterina
AU - Santi, Pier Luigi
AU - Parodi, Aurora
AU - Puppo, Francesco
AU - Campisi, Corradino
PY - 2013/8
Y1 - 2013/8
N2 - This study aimed to report new clinical approaches to the treatment of lymphatic disorders by microsurgical techniques based on histological and immunohistochemical findings. The authors' wide clinical experience in the treatment of patients with peripheral lymphedema by microsurgical techniques is reported. Microsurgical methods included derivative lymphatic-venous anastomoses and lymphatic reconstruction by interpositioned vein grafted shunts. In all patients, lymphatic and lymph nodal tissues were sent for histological assessment, together with specimen of the interstitial matrix. Diagnostic investigations consisted in venous duplex scan and lymphoscintigraphy. Results were assessed clinically by volumetry performed preoperatively and postoperatively at 3 to 6 months and at 1, 3, and 5 years. The outcome obtained in treating lymphedemas at different stages was analyzed for volume reduction, stability of results with time, reduction of dermatolymphangioadenitis attacks, necessity of wearing elastic supports, and use of conservative measures postoperatively. Microsurgical lymphatic derivative and reconstructive techniques allow bringing about positive results in the treatment of peripheral lymphedema, above all in early stages when tissular changes are slight and allow almost a complete restore of lymphatic drainage.
AB - This study aimed to report new clinical approaches to the treatment of lymphatic disorders by microsurgical techniques based on histological and immunohistochemical findings. The authors' wide clinical experience in the treatment of patients with peripheral lymphedema by microsurgical techniques is reported. Microsurgical methods included derivative lymphatic-venous anastomoses and lymphatic reconstruction by interpositioned vein grafted shunts. In all patients, lymphatic and lymph nodal tissues were sent for histological assessment, together with specimen of the interstitial matrix. Diagnostic investigations consisted in venous duplex scan and lymphoscintigraphy. Results were assessed clinically by volumetry performed preoperatively and postoperatively at 3 to 6 months and at 1, 3, and 5 years. The outcome obtained in treating lymphedemas at different stages was analyzed for volume reduction, stability of results with time, reduction of dermatolymphangioadenitis attacks, necessity of wearing elastic supports, and use of conservative measures postoperatively. Microsurgical lymphatic derivative and reconstructive techniques allow bringing about positive results in the treatment of peripheral lymphedema, above all in early stages when tissular changes are slight and allow almost a complete restore of lymphatic drainage.
KW - histopathological findings
KW - lymphedema
KW - microsurgery
KW - results
KW - techniques
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UR - http://www.scopus.com/inward/citedby.url?scp=84880546021&partnerID=8YFLogxK
U2 - 10.1097/SAP.0b013e31824f20d4
DO - 10.1097/SAP.0b013e31824f20d4
M3 - Article
C2 - 23542829
AN - SCOPUS:84880546021
VL - 71
SP - 191
EP - 195
JO - Annals of Plastic Surgery
JF - Annals of Plastic Surgery
SN - 0148-7043
IS - 2
ER -