Matching primary with secondary lymphedemas across lymphatic surgery in Genoa (Italy) from 1973 until time of COVID-19

IF 0.2 Q4 PERIPHERAL VASCULAR DISEASE
C. Campisi, M. Witte, C. Campisi, L. Molinari, E. Fulcheri, G. Villa, Samir G. Sukkar, Giovanni DE CARO, Umberto Rossi, F. Petrocelli, Mara Tacchella, Roberto Marenco, Roberto Risso, Arianna Demoro, C. Campisi
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引用次数: 0

Abstract

Authors report their pluridecennial activity (from 1973 up to today) of research, clinical experience and development of lymphatic surgery in Genoa-Italy, in close collaboration with the worldwide centers of the International Society of Lymphology. Five thousand forty-six cases of patients affected by upper and/or lower limbs, primary and secondary lymphedemas and elephantiasis, between 1973 and 2020 underwent lymphatic microsurgery;and between 2012 and 2020. fibro-lipo-lymph-aspiration. according to lymph vessel sparing procedure (FLLA-LVSP), for latest stages of lymphedema elephantiasis, previously treated by lymphatic microsurgery with partial improvement of the disease. In addition, also morbid obesity related elephantiasis, lipolympheilema/elephantiasis, chylous-lymphatic dysplastic gravitational reflux with complex related syndromes, were treated by tailored surgical procedures, properly combined with tailored medical and nutritional regimens. All patients were followed-up fora minimum of 5 years to over 20 years. Over 96% of patients with earlier stages of disease (initial lymphedema: stage IB and increasing lymphedema: stage IIA) progressively stopped using conservative therapies;and over 80% of patients with later stages (column shaped limb fibrolymphedema: stage IIB, properly called elephantiasis: stage IIIA, and extreme elephantiasis: stage IIIB), significantly decreased the frequency of physical therapies and discontinued compressive garments or stockings. Dennato-lymphangio-adenitis attacks considerably reduced by over 95%. Staging-guided treatment of peripheral lymphedema, according to authors' Genoa protocol, carries out not only the best long-lasting treatment, but also the contextual target of primary (to avoid lymphatic injuries), secondary (early-stage treatment), and tertiary (late-stage treatment) prevention in the potential worsening of the disease.
从1973年到COVID-19时期,意大利热那亚淋巴手术中原发性与继发性淋巴水肿的匹配
作者报告了他们与国际淋巴学会全球中心密切合作,在意大利热那亚进行的淋巴外科研究、临床经验和发展的多年活动(从1973年到今天)。1973年至2020年间,546例上肢和/或下肢、原发性和继发性淋巴水肿以及象皮病患者接受了淋巴显微外科手术;2012年至2020年。纤维-脂肪淋巴抽吸。根据淋巴管保留术(FLLA-LVSP),对于淋巴水肿象皮病的最新阶段,先前通过淋巴显微手术治疗,疾病得到部分改善。此外,还通过量身定制的手术程序,适当结合量身定制的医疗和营养方案,治疗了与肥胖相关的象皮病、脂肪淋巴水肿/象皮病,乳糜淋巴管发育异常重力反流伴复杂相关综合征。所有患者均进行了至少5年至20年以上的随访。超过96%的早期疾病患者(初始淋巴水肿:IB期,增加淋巴水肿:IIA期)逐渐停止使用保守治疗;超过80%的晚期患者(柱状肢体纤维淋巴水肿:IIB期,恰当地称为象皮病:IIIA期,极端象皮病:IIIB期)显著降低了物理治疗的频率,并停止了紧身衣或长筒袜。Dennato淋巴管腺炎发作显著减少95%以上。根据作者的热那亚方案,外周淋巴水肿的分期指导治疗不仅可以进行最佳的长期治疗,而且可以实现一级(避免淋巴损伤)、二级(早期治疗)和三级(晚期治疗)预防疾病潜在恶化的背景目标。
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来源期刊
CiteScore
1.00
自引率
0.00%
发文量
27
审稿时长
>12 weeks
期刊介绍: The Italian Journal of Vascular and Endovascular Surgery publishes scientific papers on vascular surgery. Manuscripts may be submitted in the form of editorials, original articles, review articles, case reports, therapeutical notes, special articles and letters to the Editor.
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