A systematic review and meta-analysis of vascularized lymph node transfer for breast cancer-related lymphedema

Contains fulltext : 251695.pdf (Publisher’s version ) (Open Access)BACKGROUND: Vascularized lymph node transfer (VLNT) has become an increasingly popular technique for treating lymphedema. However, although many studies have been performed, its efficacy in increasing patients' quality of life (QoL) and reducing lymphedema in the affected body part has remained controversial. In the present systematic review, we summarized the evidence for VLNT for treating breast cancer-related lymphedema. METHODS: The MEDLINE, Embase, and Cochrane Central databases were searched for studies of patients with breast cancer-related lymphedema who had received VLNT. The study methods were assessed using the MINORS (methodologic index for nonrandomized studies) tool. The primary outcomes were the change in volume difference between the arms and QoL. The secondary outcomes were skin infection, complications, and discontinuation of compression garment use. RESULTS: A total of 17 studies were included for qualitative synthesis and 8 for meta-analysis. The average reduction rate between the healthy and affected arms in the studies included in the meta-analysis was 40.31%. Five studies had evaluated QoL, and all five studies had reported that QoL was significantly increased. Eight studies had evaluated skin infections, of which three had reported the annual infection rates before and after surgery. In these studies, infection rate had decreased significantly. Three studies had described usage of compression garments. When the patients were pooled, 27 of 60 were able to discontinue use of the compression garment. The donor and recipient complication rates were 12.1% and 7.3%, respectively. CONCLUSIONS: The current evidence indicates that VLNT can improve the volume differences between the arms in patients with unilateral lymphedema by ∼40%. In addition, although determined from a few studies, it is likely that VLNT has a positive effect on patients' QoL, the number of skin infections, and compression garment usage and coincided with a low complication rate

Psychophysiological processing of itch in patients with chronic post-burn itch an exploratory study

FSW - Self-regulation models for health behavior and psychopathology - ou

Plastische chirurgie : een integrerend specialisme

Contains fulltext : 124116.pdf (publisher's version ) (Open Access)Rede uitgesproken bij de aanvaarding van het ambt van hoogleraar Plastische chirurgie aan het Radboudumc/ Radboud Universiteit Nijmegen op donderdag 3 oktober 201328 p

Lymphovenous Anastomosis and Secondary Resection for Noonan Syndrome with Vulvar Lymphangiectasia

Contains fulltext : 165701.pdf (publisher's version ) (Open Access)In this case report we describe the use of a 2-stage approach to treat severe recurrent vulvar lymphangiectasia in a patient with Noonan syndrome. First, 3 functional lymphatic vessels were identified and anastomosed to venules in an end-to-end fashion. Then, in a second surgical procedure, the vulvar lesions were resected as much as possible and the vulva was reconstructed. By the 12-month follow-up the patient had recovered well. Although there were still some small vesicles on the left labia there was no more ooze, itch, and pain. Lymphatic mapping using indocyanine green showed improvement of the edema of her vulva region and patent LVA. In addition to the demonstration of this 2-stage approach, this case report also demonstrates the benefits of preemptive LVA before performing surgery that may be at high risk for postoperative lymph edema

The Combined Transverse Upper Gracilis and Profunda Artery Perforator Flap for Breast Reconstruction-Letter to the Editor

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[The first bilateral hand transplantation in the Netherlands: results after 1 year]

BACKGROUND: Although more than 130 hand-arm transplantations have been performed worldwide, the first Dutch hand transplantation has been performed only recently. This bilateral hand-arm transplantation was performed in June 2019 in the Radboud University Medical Centre, Nijmegen. This report describes the preparation, procedure and 1-year follow-up results. CASE DESCRIPTION: This 44 years-old female patient had an amputation of both lower legs and hands in 2014, following a severe sepsis with peripheral tissue necrosis. The patient was mobile with her leg prostheses at the time of presentation. The loss of hand function, however, formed a continuous invalidation and could not be improved adequately with prosthesis due to the distal amputation level of her hands. CONCLUSION: The total procedure took 24 hours and was successful. Both the aesthetical and functional results were good and are still improving. The patient considered the transplanted hands immediately as her own