Surgical Approach to Lymphedema Reduction

Gallagher, Kristalyn; López, Marcos; Iles, Kathleen; Kugar, Meredith

doi:10.1007/s11912-020-00961-4

Cited by 19 publications

(15 citation statements)

References 101 publications

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“…Lymphoedema will be measured with circumferential measurements, 53 as well as a bioimpedance spectroscopy (BIS) system called SOZO ( https://www.impedimed.com/products/sozo/ ) 54 ; and categorised according to the International Society of Lymphology staging system, 55 where stage 0 is subclinical lymphoedema, and stage 3 is severe lymphoedema with >40% increase in limb volume. 56 Instead of measuring the arm’s volume, BIS uses an electrical current (painless) to scan the upper extremities by measuring the resistance to the current. A goniometer will be used to measure the shoulder ROM of both arms in degrees on a full circle, 57 and graded into a specific scale for ROM, where a deficit from 0% to 5% from full ROM=normal; 6%–15%=mild; 16%–40%=moderate; ≤40% = severe, as previously used in literature.…”

Section: Methodsmentioning

confidence: 99%

Study protocol for a 10-year prospective observational study, examining lymphoedema and patient-reported outcome after breast reconstruction

et al. 2021

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IntroductionOver the last decades, treatment of breast cancer has become increasingly more effective. Consequently, an increasing number of women are living with late effects of breast cancer treatment, including disfiguring scars, deformity or asymmetry of the breast, secondary lymphoedema and other physical and psychosocial late effects. Data from this study will provide knowledge on how to guide breast reconstruction in the future towards outcomes with fewer complications, higher long-term quality of life (QoL) and satisfaction with the aesthetic outcome. The development of secondary lymphoedema, for which the effect of breast reconstruction has yet to be established, will be thoroughly examined.Methods and analysisWomen receiving breast reconstruction (autologous and implant based) at the Department of Plastic Surgery and Burns Treatment, Rigshospitalet, will be invited to participate. The patients will be followed for 10 years postoperatively. Demographic, health-related, oncological characteristics and treatment data will be registered. Validated assessment tools, such as the BREAST-Q and Beck Depression Inventory, will be used to measure an extensive range of clinical outcomes, including QoL, life and aesthetic satisfaction and depression. Arm range of motion will be measured with a goniometer and lymphoedema by bioimpedance spectroscopy, compared with circular arm measurements.Ethics and disseminationThis study will be conducted according to the 5th version of the Helsinki Declaration. The regional ethical committee for Capital Region Denmark did not find the study notifiable, according to the law of the committee § 1, part 4. All data will be anonymised before its publication. This study will be conducted according to the Danish data protection regulation and is catalogued and approved by the Capital Region Head of Knowledge Centre. According to the Danish health law § 46, part 2, this study does not need the Danish Patient Safety Authority’s approval. The findings of this study will be submitted to international peer-reviewed journals.

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Section: Methodsmentioning

confidence: 99%

Study protocol for a 10-year prospective observational study, examining lymphoedema and patient-reported outcome after breast reconstruction

et al. 2021

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“…Also, other surgical approaches to prevent cancer-related lymphedema now are available such as the lymphatic microsurgical preventive healing approach. It seems that the management of lymphedema will be more dependent on a combination of both conservative and surgical therapies, which means the necessity of a trained multidisciplinary team of different specialties and expertise [43].…”

Section: Knowledge Of Lymphedemamentioning

confidence: 99%

Healthcare Practitioners’ Knowledge of Lymphedema

Yarmohammadi

Rooddehghan

Soltanipur

et al. 2021

International Journal of Vascular Medicine

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Objectives. Lymphedema is neglected in medical education, and a review on healthcare practitioners’ (HCPs) knowledge is necessary to shed light on gaps and to provide evidence for establishing educational programs on lymphedema. Methods. This systematic review was performed based on the PRISMA guideline in PubMed, Scopus, Web of Science, and Google Scholar databases. There was no limitation on the type of lymphedema or HCPs. The quality assessment was performed based on QATSDD. Data regarding study characteristics, questionnaire context, and findings of the study were summarized from each article. Results. After the screening, 16 articles were included that 12 were cross-sectional, two were qualitative, and two were interventional pilot studies. Breast cancer and other cancer-related lymphedema, lymphatic filariasis, and podoconiosis were included, and the majority of articles were focused on primary HCPs. The overall knowledge was low and average in five and 11 articles, respectively, and prior education was a significant factor related to higher knowledge of lymphedema in two studies. Conclusion. Structured education of lymphedema is needed to increase the knowledge of HCPs and to enhance their collaboration in multidisciplinary care teams. Improvement of HCPs’ knowledge may lead to better outcomes of lymphedema patients’ management which are neglected.

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“…4 Intraoperative intervention may be the superior option for lymphedema prevention. 10 It is important for rehabilitation clinicians to have an understanding of these surgical techniques to appreciate a patient' s risk of postoperative BCRL, adapt their prospective surveillance approach, and provide proper patient education. Therefore, the purpose of this article is to describe possible preventive surgical techniques for BCRL at the time of ALND.…”

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confidence: 99%

“…SLNB consists of removing the first draining lymph nodes in the axilla while leaving the remainder of lymph nodes intact, limiting the damage to the lymphatic system. 10 The sentinel lymph nodes are identified through injection of a radioactive dye (Tc-99 sulfur colloid) and a visible blue dye (isosulfan blue) into the breast, allowing the surgeon to identify the first draining lymph nodes. SLNB has resulted in decreased upper extremity morbidity while maintaining patient safety in terms of oncologic safety.…”

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confidence: 99%

“…SLNB has resulted in decreased upper extremity morbidity while maintaining patient safety in terms of oncologic safety. 10 A single-institution prospective study of 2940 patients who underwent SLNB with a median follow-up of 24 months identified only 47 (2%) patients with the onset of BCRL. 11 ARM is a split-mapping procedure using similar principles as SLND to intraoperatively map the lymphatic system.…”

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confidence: 99%

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