6 research outputs found
Recommended from our members
Techniques and Outcomes in Microsurgical Treatment of Post Traumatic Lymphedema: A Systematic Review
Introduction: The microsurgical treatment of lymphedema has been well studied and has been shown to be effective, especially in cancer-related lymphedema. Post traumatic lymphedema (PTL) is a debilitating condition that remains understudied and underreported, and surgical techniques for PTL treatment are not well represented in the literature. The purpose of this study was to systematically review all published reports of physiologic surgical interventions for PTL. Methods: A search was conducted of PubMed, MEDLINE, Embase, and Web of Science, from 2000 to December 6th, 2022, using keywords “PTL,” “lymphedema,” and “surgery” to identify reports of PTL treated with microsurgical lymphatic reconstruction techniques. PTL cases treated with ablation, debulking, or decongestive therapy were excluded. Results: A total of 18 records that met the inclusion criteria were identified, representing 112 patients who underwent microsurgical operations for PTL. This included 60 cases of lymph flow restoration via lymph axiality and interpositional flap transfer (LIFT), 29 vascularized lymph node transfers (VLNTs), 11 lymphatic vessel free flaps (LVFFs), 10 lymphovenous anastomoses (LVAs), and 2 autologous lymphovenous transfers (ALVTs). Outcomes were primarily reported as clinical improvement or lymph flow restoration by lymphatic imaging. All studies showed qualitative improvement of symptoms and reports with quantitative data showed statistically significant improvements. Discussion: PTL is currently underrepresented in lymphedema treatment literature, however our results show that microsurgical techniques are successful in treating lymphedema in PTL patients. Increasing awareness of PTL and establishing standardized diagnostic criteria and treatment options will help clinicians better understand how to diagnose and treat this condition. Prospective and comparative studies are needed to determine true prevalence of PTL and optimal treatment strategies
Recommended from our members
P58. RISK OF POST MASTECTOMY LYMPHEDEMA IN AUTOLOGOUS BREAST RECONSTRUCTION: A MULTI-CENTER 10-YEAR ANALYSIS OF 9,660 PATIENTS STRATIFIED BY FLAP-TYPE AND TIMING OF RECONSTRUCTION
Recommended from our members
The Impact of Implant-Based Breast Reconstruction on the Development of Breast Cancer-Related Lymphedema in Patients That Undergo Lymphatic Microsurgical Preventative Healing Approach
Recommended from our members
Prevalence, Clinical Characteristics, and Management of Silicone Lymphadenopathy: A Systematic Review of the Literature
Implant-based breast augmentations and reconstructions are one of the most common surgical procedures performed by plastic surgeons in the United States, which has rapidly increased in popularity since the 2000s. Silicone Lymphadenopathy (SL) is a complication of breast implants which involves migration of silicone to nearby soft tissue/lymph nodes. Data on its clinical features and management is scarce.
SL-related search terms were used to find articles in three databases. Of 598 articles, 101 studies met the inclusion criteria. Demographic, clinical presentation, workup, and management data were collected and analyzed.
Of 279 cases of SL and 107 with information on initial diagnosis, 35 (33%) were incidental. The most common symptom was painless lymphadenopathy followed by painful lymphadenopathy. 251 (95%) and 13 (5%) patients had silicone and saline implants, respectively. 149 (68%) patients had implant rupture. Axillary lymphadenopathy was the most affected region (136 cases, 72%), followed by internal mammary (40 cases, 21%), cervical/supraclavicular (36 cases, 19%), and mediastinal (24 cases, 13%) regions. 25% of patients underwent fine needle aspiration, 12% core needle biopsy, and 59% excisional biopsy. 32% of cases underwent explantation and/or implant exchange. The most common indication for surgery was implant rupture. Histology showed multinucleated giant cells, large histiocytes, and silicone accumulation.
Silicone lymphadenopathy is a complication associated with breast implants. The majority of patients are asymptomatic, and most cases are managed conservatively. Minority need a biopsy and surgical interventions due to abnormal imaging, persistent symptoms, and/or implant rupture. Workup and management should be tailored to the patient.
[Display omitted
Recommended from our members