Abstract
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.Whenphysiologicproceduresfailorwhenfacedwithadelayedpresentation, 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 81-92 |
| Number of pages | 12 |
| Journal | Indian Journal of Plastic Surgery |
| Volume | 52 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2019 |
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Keywords
- Lower extremity lymphedema
- Lymphedema
- Radical reduction in lymphedema with preservation of perforators
- Suction-assisted lipectomy
- Vascularized lymph node transfer
ASJC Scopus subject areas
- Surgery
Cite this
Surgical management of lower extremity lymphedema : A comprehensive review. / Ciudad, Pedro; Sabbagh, M. Diya; Agko, Mouchammed; Huang, Tony C.T.; Manrique, Oscar J.; Carmen Román, L.; Reynaga, Cesar; Delgado, Ricardo; Maruccia, Michele; Chen, Hung Chi.
In: Indian Journal of Plastic Surgery, Vol. 52, No. 1, 01.01.2019, p. 81-92.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Surgical management of lower extremity lymphedema
T2 - A comprehensive review
AU - Ciudad, Pedro
AU - Sabbagh, M. Diya
AU - Agko, Mouchammed
AU - Huang, Tony C.T.
AU - Manrique, Oscar J.
AU - Carmen Román, L.
AU - Reynaga, Cesar
AU - Delgado, Ricardo
AU - Maruccia, Michele
AU - Chen, Hung Chi
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.Whenphysiologicproceduresfailorwhenfacedwithadelayedpresentation, 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.
AB - 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.Whenphysiologicproceduresfailorwhenfacedwithadelayedpresentation, 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.
KW - Lower extremity lymphedema
KW - Lymphedema
KW - Radical reduction in lymphedema with preservation of perforators
KW - Suction-assisted lipectomy
KW - Vascularized lymph node transfer
UR - http://www.scopus.com/inward/record.url?scp=85069532417&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85069532417&partnerID=8YFLogxK
U2 - 10.1055/s-0039-1688537
DO - 10.1055/s-0039-1688537
M3 - Review article
VL - 52
SP - 81
EP - 92
JO - Indian Journal of Plastic Surgery
JF - Indian Journal of Plastic Surgery
SN - 0970-0358
IS - 1
ER -