IF 2.5 4区医学

Lymphology Pub Date : 2024-04-15 DOI: 10.2458/lymph.6067

K. Dalcı, S. Gumus, A. G. Sarıtaş, H. B. Onan, A. T. Akeam, A. Ulku, G. Sakman

{"title":"Multimodal Treatment of Chylous Fistula: A Retrospective Case-Control Study.","authors":"K. Dalcı, S. Gumus, A. G. Sarıtaş, H. B. Onan, A. T. Akeam, A. Ulku, G. Sakman","doi":"10.2458/lymph.6067","DOIUrl":"https://doi.org/10.2458/lymph.6067","url":null,"abstract":"Chylous fistulas (CF) are rare surgical complications and there is no standard treatment. This study presents the treatment modalities performed on patients who developed CF over a 10-year period. During the observation period, CF developed in 29 patients, 16 of whom were women. The mean age was 55.76± 13.48. Lymphatic duct injury was mostly seen in the abdomen (58.6%) and the most common reason was nephrectomy (20.7%). Extended lymphatic dissection due to malignancy was performed in 82.7% of all cases. Chylous leakage started postoperatively on 3.78±3.94 days (range: 1-19 days). Fasting, total parenteral nutrition (TPN), and somatostatin treatment were applied to all patients, and 75.8% of the fistulas were resolved completely with medical treatment. Surgical ligation of the lymphatic canal was performed in 7 patients. One was not successful and underwent percutaneous embolization of the thoracic lymphatic leakage cavity. All fistulas were resolved in 18.18±10.4 days. The resolution time and hospital stay were significantly higher in thoracic fistulas (p=0.017; p=0.003, respectively). In addition, malignant cases had longer resolution time (32.40±28.72 vs 16.27±11.25, p=0.036) and hospital stay (35.0±29.74 vs 16.25±14.05p= 0.002 respectively) than non-malignant. There was no chylothorax, chylous ascites, or recurrence at 20.55±22.88 months follow-up. Treatment of CF with fasting, TPN, and somatostatin analogs are effective. Other interventions such as surgical ligation with or without fibrin glue and interventional radiology treatments may be considered when conservative treatments fail.","PeriodicalId":51122,"journal":{"name":"Lymphology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140700735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Addition of Intermittent Pneumatic Compression to Conventional Treatment Improves Volume Reduction Before Lymphatic Surgery for Lower Limb Lymphedema: A Pilot Study. 在常规治疗的基础上增加间歇性气压疗法可改善下肢淋巴水肿手术前的体积缩小效果：试点研究。

IF 2.5 4区医学

Lymphology Pub Date : 2024-04-14 DOI: 10.2458/lymph.6066

C. Campisi, E. Parodi, A. Demoro, R. Risso, W. D. Brinda, C. Campisi

{"title":"Addition of Intermittent Pneumatic Compression to Conventional Treatment Improves Volume Reduction Before Lymphatic Surgery for Lower Limb Lymphedema: A Pilot Study.","authors":"C. Campisi, E. Parodi, A. Demoro, R. Risso, W. D. Brinda, C. Campisi","doi":"10.2458/lymph.6066","DOIUrl":"https://doi.org/10.2458/lymph.6066","url":null,"abstract":"This study assesses the impact of an advanced intermittent pneumatic compression device (IPC - Lympha Press® Optimal Plus) when added to Complete Decongestive Therapy (CDT) compared to CDT alone on volume reduction of limbs with lymphedema. The goal is to maximally reduce edema in preparation for microsurgery. Fifty subjects scheduled for Multiple Lymphatic-Venous Anastomosis (MLVA) were randomly (sequentially) assigned to experimental or control group: 25 (21 females and 4 males) in the experimental IPC group and 25 (20 females and 5 males) in the control group. The two groups were similar in age, sex distribution, and type of lymphedema. Results indicate the IPC group reported greater volume loss than the control group (p= 0.00137) comparing final vs. initial limb volume. The average percentage edema volume loss achieved with added IPC was two times greater (11.7%) than in the control group (5.0%). When differences in treatment duration were accounted for, the IPC group achieved consistently greater proportional volume loss (12.83% vs 6.30%) than conservative therapy alone. In our pilot study, IPC added to CDT resulted in greater proportional volume loss and provides better preparation for MLVA surgery.","PeriodicalId":51122,"journal":{"name":"Lymphology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Modified Lymphoscintigraphy in Primary Lymphatic Insufficiency of the Lower Limb. 原发性下肢淋巴功能不全的改良淋巴管造影术

IF 2.5 4区医学

Lymphology Pub Date : 2024-04-14 DOI: 10.2458/lymph.6065

M. Wald, J. Svobodova, H. Krizova

{"title":"Modified Lymphoscintigraphy in Primary Lymphatic Insufficiency of the Lower Limb.","authors":"M. Wald, J. Svobodova, H. Krizova","doi":"10.2458/lymph.6065","DOIUrl":"https://doi.org/10.2458/lymph.6065","url":null,"abstract":"Primary lymphedema of the foot and toes could be sometimes misdiagnosed by lymphoscintigraphy as a whole lower limb lymphatic insufficiency (LLLI). This is caused by using standard lymphoscintigraphic protocol based on one interstitial injection of radiotracer applied into the first interdigital space followed by image analysis of lower limb lymphatic vessels and lymph nodes. Here, we show that a modification of the lymphoscintigraphic protocol and introduction of a second dose of radiotracer right above the inner ankle to the clinically healthy tissue can more accurately describe morphological abnormalities of the superficial lymphatic system at the lower limb and thereby refine the diagnosis of the LLLI. Fourteen patients with swelling of the foot and toes (16 lower limbs) were examined using standard lymphoscintigraphic protocol. Subsequently, modified lymphoscintigraphy was performed. While standard lymphoscintigraphy showed severe lymphatic insufficiency of the superficial lymphatic system in all 14 patients (in 16 lower limbs), including significantly reduced number of inguinal nodes, modified lymphoscintigraphy revealed almost normal morphology of superficial lymphatic vessels in 11 patients (in 13 lower limbs) throughout the entire lower limb proximal to the application site. In conclusion, using the modified lymphoscintigraphy protocol in patients with foot and toes primary lymphedema can refine diagnosis and follow-up medical management.","PeriodicalId":51122,"journal":{"name":"Lymphology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140704489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Underreporting and Underrepresentation of Racial and Ethnic Minority Patients in Lymphedema Clinical Trials: A Systematic Review. 淋巴水肿临床试验中少数种族和族裔患者的报告不足和代表性不足：系统回顾。

IF 2.5 4区医学

Lymphology Pub Date : 2024-04-14 DOI: 10.2458/lymph.6064

M. J. Escobar-Domingo, V. P. Bustos, J. E. Fanning, J. Foppiani, E. Kim, A. Hernandez-Alvarez, S. J. Lin, D. Singhal, B. T. Lee

{"title":"Underreporting and Underrepresentation of Racial and Ethnic Minority Patients in Lymphedema Clinical Trials: A Systematic Review.","authors":"M. J. Escobar-Domingo, V. P. Bustos, J. E. Fanning, J. Foppiani, E. Kim, A. Hernandez-Alvarez, S. J. Lin, D. Singhal, B. T. Lee","doi":"10.2458/lymph.6064","DOIUrl":"https://doi.org/10.2458/lymph.6064","url":null,"abstract":"The generalizability of findings from Clinical Trials (CTs) investigating lymphedema treatment modalities requires an accurate representation of the target population. This study aims to evaluate racial and ethnic reporting and representation in lymphedema CTs. A comprehensive systematic literature search was conducted during May 2023 using multiple databases, following the PRISMA guidelines. All CTs published from 2018 to 2023 were included. A total of 84 articles were included in this review, from which 6,546 participants were included in the analysis. Seventy-four (88.1%) articles addressed secondary lymphedema, of which 60 (81.1%) were related to breast cancer. Only 12 (13%) of CTs reported at some extend race or ethnicity. Of these, five (41.6%) reported race and two (16.6%) reported ethnicity according to FDA guidelines. White race had the highest pooled prevalence (80%; 95% CI 72-86%; I2=90%), followed by Black (7%; 95% CI 2- 15%; I2= 94.3%) and Asian (4%; 95% CI 1-8%; I2= 89.9%). In studies reporting ethnicity, participants were predominantly non-Hispanic (92.1%; 95% CI 90 - 94%). There is an underreporting and underrepresentation of racial and ethnic minorities among lymphedema CTs, limiting their generalizability. It is imperative to future development of strategies to enhance diversity in the study sample.","PeriodicalId":51122,"journal":{"name":"Lymphology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140705221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

ISL NEWS ISL 新闻

IF 2.5 4区医学

Lymphology Pub Date : 2024-04-14 DOI: 10.2458/lymph.6068

Isl News

引用次数: 0

Defocused and Radial Shock Wave Therapy, Mesotherapy, and Kinesio Taping Effects in Patients with Lipedema: A Pilot Study. 脂肪性水肿患者的聚焦和径向冲击波疗法、中胚层疗法和肌动贴效果：试点研究

IF 2.5 4区医学

Lymphology Pub Date : 2023-11-29 DOI: 10.2458/lymph.5872

S. Michelini, F. Musa, M. Vetrano, F. Santoboni, S. M. Nusca, E. Latini, D. Trischitta, S. Michelini, M. Iosa, M. Vulpiani

{"title":"Defocused and Radial Shock Wave Therapy, Mesotherapy, and Kinesio Taping Effects in Patients with Lipedema: A Pilot Study.","authors":"S. Michelini, F. Musa, M. Vetrano, F. Santoboni, S. M. Nusca, E. Latini, D. Trischitta, S. Michelini, M. Iosa, M. Vulpiani","doi":"10.2458/lymph.5872","DOIUrl":"https://doi.org/10.2458/lymph.5872","url":null,"abstract":"The aim of this pilot study was to investigate the effects of defocused and radial shock wave therapy, mesotherapy, and kinesio taping on pain, circumferences of lower limbs, echographic/ elastosonographic pattern of subcutaneous adipose tissue (SAT), and quality of life in patients with lipedema. Fifteen women affected by lower limb lipedema in stage II were treated with shock wave therapy, mesotherapy, and kinesio taping on thighs and legs (eight sessions, twice a week). The primary outcome was pain, as assessed by Numeric Rating Scale (NRS). Secondary outcomes included the limb circumferences measurements, the SF-12 Health Survey for quality of life, the International Classification of Functioning (ICF) for disability, and echographic/ elastosonographic changes of SAT. Significant reductions of pain and circumference measurements were seen in patients at each follow up. This was associated with significant reduction of thickness, echographic pattern improvement, and increased elasticity of SAT, with consequent positive impact on the quality of life and disability reported by the patients. The results demonstrate improved clinical and functional ultrasound findings in patients affected by lipedema in the early stages of lower limbs, and this combination therapy needs to be investigated in larger populations at multiple centers to confirm the findings.","PeriodicalId":51122,"journal":{"name":"Lymphology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139210021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Oncolymphology: Immune Interactions and Cancer. 肿瘤淋巴学：免疫相互作用与癌症

IF 2.5 4区医学

Lymphology Pub Date : 2023-11-29 DOI: 10.2458/lymph.5870

S. P. Leong

引用次数: 0

ISL NEWS ISL 新闻

IF 2.5 4区医学

Lymphology Pub Date : 2023-11-29 DOI: 10.2458/lymph.5874

Isl News

引用次数: 0

Does Liposuction for Lymphedema Worsen Lymphatic Injury? 淋巴水肿吸脂手术会加重淋巴损伤吗？

IF 2.5 4区医学

Lymphology Pub Date : 2023-11-29 DOI: 10.2458/lymph.5871

W. F. Chen, S. K. Pandey, J. N. Lensing

{"title":"Does Liposuction for Lymphedema Worsen Lymphatic Injury?","authors":"W. F. Chen, S. K. Pandey, J. N. Lensing","doi":"10.2458/lymph.5871","DOIUrl":"https://doi.org/10.2458/lymph.5871","url":null,"abstract":"Liposuction for treatment of lymphedema is an effective and time-tested treatment. However, as there is a fear regarding further lymphatic damage caused by liposuction, we objectively compared lymphatic function pre- and post-liposuction. All patients with solid-predominant lymphedema who were treated during the study period of June 2014 and November 2018 were included. Patients were assessed using patient-reported baselines/outcomes, lymphedema- specific quality of life scale (LYMQOL), limb circumference/volume measurements, and indocyanine green lymphography (ICGL) preoperatively and at predefined postoperative time intervals. Fifty-seven limbs from 41 patients were included. Mean lipoaspirate volumes were 2035 mL, 5385 mL, and 3106 mL for the arm, thigh, and leg, respectively with a mean adipose fraction of the lipoaspirate of 71%. All patients underwent redundant skin excision with the \"flying squirrel\" technique. The mean follow-up was 10.7 months (range 3 - 48 months) with a mean limb volume reduction of 32.2% and all patients reporting satisfactory relief of symptoms. All showed statistically significant improvement in LYMQOL in symptoms, appearance, and function. On ICGL, none showed worsened lymphatic drainage, rather, all showed improved lymph drainage. Furthermore, the improved lymph drainage was found to be progressive during the study period in all patients. Our study results demonstrate that treating extremity lymphedema with liposuction does not worsen lymphatic function and in fact, paradoxically, it induces progressive improvement in lymph drainage.","PeriodicalId":51122,"journal":{"name":"Lymphology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139211695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Can Acupuncture be a Part of the Treatment for Breast Cancer-Related Lymphedema? A Systematic Review of the Safety and Proposed Model for Care. 针灸可以作为乳腺癌相关淋巴水肿治疗的一部分吗？安全性系统回顾及护理模式建议。

IF 2.5 4区医学

Lymphology Pub Date : 2023-11-29 DOI: 10.2458/lymph.5873

J. K. Kim, C. Loo, J. S. Kim, C. Pranskevich, O. K. Gordon

{"title":"Can Acupuncture be a Part of the Treatment for Breast Cancer-Related Lymphedema? A Systematic Review of the Safety and Proposed Model for Care.","authors":"J. K. Kim, C. Loo, J. S. Kim, C. Pranskevich, O. K. Gordon","doi":"10.2458/lymph.5873","DOIUrl":"https://doi.org/10.2458/lymph.5873","url":null,"abstract":"Acupuncture is a potential therapy for breast cancer-related lymphedema (BCRL). Despite a recent meta-analysis on efficacy, data on acupuncture safety in BCRL are lacking. Current clinical guidelines recommend avoiding needling in the upper extremity affected by lymph node dissection. We undertook a systematic review focusing on acupuncture safety and treatment protocols in clinical trials for BCRL. Literature searches were conducted in PubMed, Ovid, CINAHL, and Cochrane library. Eight clinical trials on acupuncture for BCRL were analyzed. The Standards of Acupuncture intervention (STRICTA 2010) and Cochrane risk of bias (RoB2 2019) were applied to assess methods for acupuncture interventions within Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Quantity and severity of adverse events (AE) were reviewed. A total of 189 subjects participated in 8 clinical trials with 2965 acupuncture treatments. No serious adverse events (SAE) were reported regardless of treatment laterality or protocol, with only a single grade 2 skin infection in 2,965 total treatments (0.034%), including 1,165 bilateral and 225 ipsilateral treatments. Our comprehensive review of clinical trials of acupuncture for BCRL demonstrated no significant adverse events in 2,965 treatments, including 1,390 in the affected limb. An approach for routine integration of acupuncture into BCRL maintenance therapy is proposed.","PeriodicalId":51122,"journal":{"name":"Lymphology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139210720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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