Lymphedema Liposuction with Immediate Limb Contouring

Chen, Wei-Fan; Zeng, Weifeng; Hawkes, Patrick J.; Man, Jeanette H.; Bowen, Mindy

doi:10.1097/gox.0000000000002513

Cited by 15 publications

(7 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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). These patients need to be on lifelong compression garments.…”

Section: Management Of Lymphedema By Multi-modalities Treatmentmentioning

confidence: 99%

The Unresolved Pathophysiology of Lymphedema

et al. 2020

View full text Add to dashboard Cite

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.

show abstract

Section: Management Of Lymphedema By Multi-modalities Treatmentmentioning

confidence: 99%

The Unresolved Pathophysiology of Lymphedema

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Brorson reported that liposuction combined with postoperative controlled compression therapy (CCT) is effective for the treatment of limb lymphedema [9]. Chen et al and Chollet et al found that in liposuction without concurrent skin excision, the skin often does not sufficiently retract and can lead to wound healing complications [10,11]. However, the research results of Qi showed that limb volume reduction was noted in all cases immediately after the operation, but this state of volume reduction remained at 3 to 12 months with a mean of 6.01 months, when low-stretch bandages or compression stockings were applied.…”

Section: Introductionmentioning

confidence: 99%

Liposuction in cancer-related lower extremity lymphedema: an investigative study on clinical applications

et al. 2022

View full text Add to dashboard Cite

Background Lymphedema is a progressive, noncurable condition consisting of increases in subcutaneous fat and interstitial fluid in the limbs and fibrosis during later stages. The disease most commonly affects the limbs following injury to or removal of the lymph nodes. The aim of this study was to investigate the therapeutic outcomes of liposuction for cancer-related lower extremity lymphedema. Methods Sixty-two patients with cancer-related lymphedema in the unilateral lower extremity were recruited for this study, and all patients underwent liposuction. The volume of hemorrhage and lipids, the operation time, and the volume changes of the affected extremity were compared by applying the t tests, and the subjective feelings of patients were compared with the chi-square tests. Results The total lipid volume was 2539 ± 1253.5 ml, and the hemorrhage volume was 828 ± 311.8 ml. For the comparison of objective indices, (1) the percent volume differences (PVDs) before surgery, intraoperatively, and at the 3-month follow-up were 5.5 ± 12.2 vs. 11.6 ± 18.4 vs. 43.2 ± 23.7, P < 0.05, respectively; (2) greater lipid volumes and higher liposuction rates were observed for female patients, as was a smaller volume of hemorrhage; (3) greater hemorrhage volumes were observed in patients with a history of recurrent erysipelas; and (4) greater lipid volumes and liposuction rates (LRs) and smaller hemorrhage volumes were observed for stage II than for stage III patients. Conclusions Liposuction is an effective therapy for cancer-related lower extremity lymphedema. Sex, stage, and recurrent erysipelas history influence the course and effect of liposuction.

show abstract

“…Seven studies reporting surgical complications of SAL were documented (see Supplementary Table S3 [available in the online version], which displays an overview of the included studies). 6 56 57 58 59 A summary of the reported complications is exhibited in Table 4 . The most common complications reported were significant blood loss ( n = 30, 30.30%), transient paresthesia of the limb ( n = 32, 32.32%), contour irregularities ( n = 13, 13.13%), skin necrosis ( n = 6, 6.6%), and hematoma or seroma formation ( n = 8, 8.8%).…”

Section: Resultsmentioning

confidence: 99%

Lessons Learnt from an 11-year Experience with Lymphatic Surgery and a Systematic Review of Reported Complications: Technical Considerations to Reduce Morbidity

et al. 2022

View full text Add to dashboard Cite

Complications experienced during lymphatic surgery have not been ubiquitously reported, and little has been described regarding how to prevent them. We present a review of complications reported during the surgical management of lymphedema and our experience with technical considerations to reduce morbidity from lymphatic surgery. A comprehensive search across different databases was conducted through November 2020. Based on the complications identified, we discussed the best approach for reducing the incidence of complications during lymphatic surgery based on our experience. The most common complications reported following lymphovenous anastomosis were re-exploration of the anastomosis, venous reflux, and surgical site infection. The most common complications using groin vascularized lymph node transfer (VLNT), submental VLNT, lateral thoracic VLNT, and supraclavicular VLNT included delayed wound healing, seroma and hematoma formation, lymphatic fluid leakage, iatrogenic lymphedema, soft-tissue infection, venous congestion, marginal nerve pseudoparalysis, and partial flap loss. Regarding intra-abdominal lymph node flaps, incisional hernia, hematoma, lymphatic fluid leakage, and postoperative ileus were commonly reported. Following suction-assisted lipectomy, significant blood loss and transient paresthesia were frequently reported. The reported complications of excisional procedures included soft-tissue infections, seroma and hematoma formation, skin-graft loss, significant blood loss, and minor skin flap necrosis. Evidently, lymphedema continues to represent a challenging condition; however, thorough patient selection, compliance with physiotherapy, and an experienced surgeon with adequate understanding of the lymphatic system can help maximize the safety of lymphatic surgery.

show abstract

Lymphedema Liposuction with Immediate Limb Contouring

Cited by 15 publications

References 38 publications

The Unresolved Pathophysiology of Lymphedema

The Unresolved Pathophysiology of Lymphedema

Liposuction in cancer-related lower extremity lymphedema: an investigative study on clinical applications

Lessons Learnt from an 11-year Experience with Lymphatic Surgery and a Systematic Review of Reported Complications: Technical Considerations to Reduce Morbidity

Contact Info

Product

Resources

About