Suction Lipectomy in the Management of Limb Lymphedema

Sando, William C.; Nahai, Foad

doi:10.1016/s0094-1298(20)31352-3

Cited by 46 publications

(4 citation statements)

References 28 publications

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“…By removing the excess adipose tissue the risk of developing lymphangiosarcoma will decrease. Preliminary clinical reports, although not impressive, warranted further refinement and evaluation of the procedure (29,30).…”

Section: Liposuctionmentioning

confidence: 99%

Liposuction in Arm Lymphedema Treatment

Brorson

2003

Scand J Surg

127

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Breast cancer is the most common disease in women, and up to 38% develop lymphedema of the arm following mastectomy, standard axillary node dissection and postoperative irradiation. Limb reductions have been reported utilizing various conservative therapies such as manual lymph and pressure therapy. Some patients with long-standing pronounced lymphedema do not respond to these conservative treatments because slow or absent lymph flow causes the formation of excess subcutaneous adipose tissue. Previous surgical regimes utilizing bridging procedures, total excision with skin grafting or reduction plasty seldom achieved acceptable cosmetic and functional results. Microsurgical reconstruction involving lympho-venous shunts or transplantation of lymph vessels has also been investigated. Although attractive in concept, the common failure of microsurgery to provide complete reduction is due to the persistence of newly formed subcutaneous adipose tissue, which is not removed in patients with chronic non-pitting lymphedema. Liposuction removes the hypertrophied adipose tissue and is a prerequisite to achieve complete reduction. The new equilibrium is maintained through constant (24-hour) use of compression garments postoperatively. Long-term follow up (7 years) does not show any recurrence of the edema.

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Section: Liposuctionmentioning

confidence: 99%

Liposuction in Arm Lymphedema Treatment

Brorson

2003

Scand J Surg

127

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“…In 1989, O’Brien and colleagues 13 from Melbourne published a preliminary report of 19 patients who underwent liposuction for lymphedema. They reported “objective improvement in 10 of the 11 patients with unilateral lymphedema, with an average reduction of 23% of the excess volume.” Around the same time, Sando and Nahai 14 from the United States reported a similar experience in 15 patients with lymphedema, with average volume reductions of 8%.…”

mentioning

confidence: 81%

Liposuction for Advanced Lymphedema in a Multidisciplinary Team Setting in Australia – Five-Year Follow-Up

Karlsson

Mackie

Koelmeyer

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Liposuction for International Society of Lymphology late stage 2 or 3 limb lymphedema is an established surgical option to remove excessive adipose tissue deposition and has been performed in Australia since 2012 at the Australian Lymphoedema Education, Research, and Treatment (ALERT) Program of Macquarie University. Methods: Between May of 2012 and May of 2017, 72 patients with unilateral primary or secondary lymphedema of the arm or leg underwent suction-assisted lipectomy using the Brorson protocol. This prospective study presents 59 of these patients who had consented to research with a 5-year follow-up. Results: Of the 59 patients, 54 (92%) were women, 30 (51%) had leg lymphedema, and 29 (49%) had arm lymphedema. For patients with arm lymphedema, the median preoperative volume difference between the lymphedematous and the contralateral arm was 1061 mL, which was reduced to 79 mL 1 year after surgery and to 22 mL 5 years after surgery. For patients with leg lymphedema, the median preoperative volume difference was 3447 mL, which was reduced to 263 mL 1 year after surgery but increased to 669 mL 5 years after surgery. Conclusion: Suction-assisted lipectomy is a long-term option for the management of selected patients with International Society of Lymphology late stage 2 or 3 limb lymphedema when conservative management can offer no further improvement. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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“…Early reports of lower extremity liposuction were disappointing, resulting in minor improvements when performed without skin excisions. 14 However, liposuction techniques and equipment improvements have increased this operation’s efficacy. In 2016, Brorson described excellent long-term results using power-assisted liposuction with the help of tumescent technique and tourniquet to reduce blood loss.…”

Section: Ablative and Debulking Surgerymentioning

confidence: 99%

Genital elephantiasis: Surgical treatment and reconstruction

Sun,

Yamamoto

2023

Journal of the Chinese Medical Association

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Genital elephantiasis is a severe form of lymphedema of the groin. It is characterized by progressive enlargement and distortion of the genitals, presenting significant physical, psychological, and social challenges to the affected individuals. While pharmacological treatment of filariasis is well-established in the medical field, the surgical management of genital elephantiasis can be varied and confusing. This review article provides an in-depth analysis of the etiology, classification, severity grading, and various effective surgical treatment and reconstructive modalities commonly employed by surgeons since the early 20 th Century. We also discuss how a combination approach of ablation, soft tissue coverage, and lymphatic reconstruction is viable for treating genital elephantiasis. By examining the literature, we hope to provide insights into how surgery plays a role in the holistic management of genital elephantiasis.

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Suction Lipectomy in the Management of Limb Lymphedema

Cited by 46 publications

References 28 publications

Liposuction in Arm Lymphedema Treatment

Liposuction in Arm Lymphedema Treatment

Liposuction for Advanced Lymphedema in a Multidisciplinary Team Setting in Australia – Five-Year Follow-Up

Genital elephantiasis: Surgical treatment and reconstruction

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