Lymphoedema surveillance after groin node dissection

The experiences, occupational performance impacts and needs of people who are at risk of, or have developed lymphoedema following groin or pelvic node dissection for Metastatic Melanoma: an interpretive descriptive study

“…The authors concluded that further investigations were required, and that education, surveillance and early detection and intervention might be a more economical way forward. Surveillance models for ULL and LLL have been supported by other researchers (Armer et al, 2013;Binkley et al, 2012;Boccardo et al, 2009;Lloyd, 2013;Ostby et al, 2014;Stout et al, 2012a) but are not common practice in clinical settings for LLL now.…”

“…Studies evaluating prevention programs have small numbers and involve participants with varying diagnoses making it very difficult to cite any significant evidence base. Recommendations for LLL prospective surveillance and early intervention strategies exist (Lloyd, 2013;Lloyd et al, 2014) with more research available in the field of BCRL (Box, Reul-Hirche, Bullock-Saxton, & Furnival, 2002;Lacomba, 2010;Singh, De Vera, & Campbell, 2013;Stout et al, 2012b). Historically, lymphoedema treatments commenced when an individual developed LLL and was referred by their medical specialist.…”

“…Not surprisingly, it has been recognised that early intervention in lymphoedema improves treatment outcome (Armer et al, 2013;International Lymphoedema Framework, 2006;Kerchner, Fleischer, & Yosipovitch, 2008) and that a persons' level of knowledge and belief, or self-efficacy in being able to control lymphoedema contributes to improved risk reduction factors (Lindquist et al, 2015;Sherman & Koelmeyer, 2013). Whilst surveillance models promoting early identification of LLL have been encouraged (Binkley et al, 2012;Lloyd, 2013;Singh et al, 2013), few studies have attempted to explore the impact of proactive preventative programs regarding burden of care and occupational performance for individuals.…”

“…Consequently, functional impairments due to LLL following MM mirrored those of LLL from other causes and included problems such as difficulty donning and doffing garments, getting dressed, slowing transfers and mobility due to the increased size and reduced ROM of the leg, impacting on travel and work due to the problems with sitting for long periods, and impacting on intimacy. (Cheville, 2010;Koelmeyer, 2016;Stout et al, 2012b;Yang et al, 2016) and gynaecological cancers (Lloyd, 2013) cite physical and economic benefits as important outcomes, the evidence-base and clinical uptake of such programs for LLL remain limited. This study provides new information regarding perceptions of surveillance for LLL as well as feedback regarding a proactive LLL prevention program.…”

“…All people in this study were receiving proactive monitoring and assessment for LLL following ilioinguinal node dissection for stage III MM. Whilst surveillance models have been encouraged by researchers for ULL (Armer et al, 2013;Blaney et al, 2015;Koelmeyer, 2016;Stout et al, 2012a) and LLL (Lloyd, 2013), the traditional mode of referral of people to lymphoedema therapists following inguinal or ilioinguinal node dissection normally occurs only when their treating surgeon identifies leg swelling at a follow-up appointment. The findings indicated that people experienced monitoring for LLL as a positive process and felt that formal assessment, education and feedback by a trained lymphoedema therapist kept them accountable in terms of looking after their leg, weight control, exercise and self-monitoring.…”