Liposuction Gives Complete Reduction of Arm Lymphedema following Breast Cancer Treatment—A 5-year Prospective Study in 105 Patients without Recurrence

Hoffner, Mattias; Ohlin, Karin; Svensson, Britt-Marie; Manjer, Jonas; Hansson, Emma; Troëng, Thomas; Brorson, Håkan

doi:10.1097/gox.0000000000001912

Cited by 55 publications

(62 citation statements)

References 46 publications

(46 reference statements)

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“…The indication for liposuction is fat hypertrophy in the affected extremities as shown on MRI. Proponents of liposuction demonstrate good volume reduction and no recurrence after 5 years (Hoffner et al, 2018a). The risks of liposuction include blood loss, hematoma, contour irregularity, and skin necrosis (Chen et al, 2019).…”

Section: Management Of Lymphedema By Multi-modalities Treatmentmentioning

confidence: 99%

The Unresolved Pathophysiology of Lymphedema

et al. 2020

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Lymphedema is the clinical manifestation of impaired lymphatic transport. It remains an under-recognized and under-documented clinical condition that still lacks a cure. Despite the substantial advances in the understanding of lymphatic vessel biology and function in the past two decades, there are still unsolved questions regarding the pathophysiology of lymphedema, especially in humans. As a consequence of impaired lymphatic drainage, proteins and lipids accumulate in the interstitial space, causing the regional tissue to undergo extensive and progressive architectural changes, including adipose tissue deposition and fibrosis. These changes are also associated with inflammation. However, the temporal sequence of these events, the relationship between these events, and their interplay during the progression are not clearly understood. Here, we review our current knowledge on the pathophysiology of lymphedema derived from human and animal studies. We also discuss the possible cellular and molecular mechanisms involved in adipose tissue and collagen accumulation during lymphedema. We suggest that more studies should be dedicated to enhancing our understanding of the human pathophysiology of lymphedema to pave the way for new diagnostic and therapeutic avenues for this condition.

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Section: Management Of Lymphedema By Multi-modalities Treatmentmentioning

confidence: 99%

The Unresolved Pathophysiology of Lymphedema

et al. 2020

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“…Volume reduction was greater in the combined group, but the difference was not statistically significant (P = 0.28). The outcome of maintaining reduced volume seven days after removing compression garments following the combination therapy is interesting because compression garments are needed to maintain the reduced volume achieved in patients treated only with lipoaspiration, and removing compression garments for one week one year post liposuction has led to an increase in volume up to 370 mL [14][15]. Some studies have suggested that lymph node transfer promotes regeneration of lymphatic tissue three months after surgery [16][17].…”

Section: Discussionmentioning

confidence: 99%

Lipoaspiration and Lymph Node Transfer for Treatment of Breast Cancer-related Lymphedema: A Systematic Review

Forte

Huayllani

Boczar

et al. 2019

Cureus

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Lipoaspiration and venous lymph node transfer have each been described as procedures that would improve symptoms of lymphedema. We aim to describe the efficacy of the combination of lipoaspiration and lymph node transfer and to report the outcomes in breast cancer-related lymphedema patients. The search was conducted by querying the PubMed, EMBASE, and Ovid Medline databases for studies that considered the use of lipoaspiration and venous lymph node transfer as surgical treatment for breast cancer-related lymphedema. Different combinations of the keywords "aspiration lipectomy" AND "lymphedema" AND "lymph node transfer" were used for the search. From a total of 20 articles, five met inclusion criteria. All patients included in these studies had stage II or III lymphedema. Two studies considered lipoaspiration as the first step followed by lymph node transfer, two considered lymph node transfer as the first step followed by lipoaspiration, and one applied both procedures simultaneously. A meaningful volume reduction was achieved in all cases. Patients who underwent lymph node transfer first followed by lipoaspiration appeared to have the best outcomes. This systematic review suggests that the combination of lymph node transfer and lipoaspiration is a potential surgical treatment that may improve outcomes achieved by one single procedure in patients with stage II to III breast cancer-related lymphedema.

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“…For best results, it is advised to wear the garment lifelong [57] . Hoffner et al [58] have shown a mean 5-year postoperative reduction of 117% ± 26% in the limb with lymphoedema compared with the healthy arm.…”

Section: Liposuctionmentioning

confidence: 97%

Surgical debulking, lymphatico venous anastomosis, vascularised lymph node transfer in lower limb lymphoedema

Venkatramani¹,

Shanmugakrishnan²,

Kumaran³

et al. 2020

PAR

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Lymphoedema is a chronic debilitating disease of the lymphatic system that occurs due to either abnormal development or damage of the lymphatics resulting from cancer or infection. The optimal treatment of lymphoedema is still elusive. Management is tailored according to clinical features, investigations and expectations of each patient. Lymphoedema patients should undergo a trial of conservative management with compression therapy, manual lymphatic drainage and external sequential compression devices. Early lymphoedema is treated by lymphovascular anastomosis, where the lymph vessels are connected to the subdermal veins by supermicrosurgery. In late cases when the limb is fibrotic, vascularised lymph node transfers are done, where lymph nodes are transferred from a healthy area to the affected area. In advanced cases, when the limb is fibrotic with cutaneous folds and skin changes, surgical debulking is done. In lymphoedema, along with accumulation of lymphatic tissue, there is also fat deposition, which can be removed by liposuction. One should be conversant with all treatment modalities to provide the lymphoedema patient with optimal care.

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Liposuction Gives Complete Reduction of Arm Lymphedema following Breast Cancer Treatment—A 5-year Prospective Study in 105 Patients without Recurrence

Cited by 55 publications

References 46 publications

The Unresolved Pathophysiology of Lymphedema

The Unresolved Pathophysiology of Lymphedema

Lipoaspiration and Lymph Node Transfer for Treatment of Breast Cancer-related Lymphedema: A Systematic Review

Surgical debulking, lymphatico venous anastomosis, vascularised lymph node transfer in lower limb lymphoedema

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