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- Boyages, John, et al.
(författare)
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Liposuction for Advanced Lymphedema: A Multidisciplinary Approach for Complete Reduction of Arm and Leg Swelling
- 2015
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Ingår i: Annals of Surgical Oncology. - : Springer Science and Business Media LLC. - 1534-4681 .- 1068-9265. ; 22, s. 1263-1270
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. This research describes and evaluates a liposuction surgery and multidisciplinary rehabilitation approach for advanced lymphedema of the upper and lower extremties. Methods. A prospective clinical study was conducted at an Advanced Lymphedema Assessment Clinic (ALAC) comprised of specialists in plastic surgery, rehabilitation, imaging, oncology, and allied health, at Macquarie University, Australia. Between May 2012 and 31 May 2014, a total of 104 patients attended the ALAC. Eligibility criteria for liposuction included (i) unilateral, non-pitting, International Society of Lymphology stage II/III lymphedema; (ii) limb volume difference greater than 25 %; and (iii) previously ineffective conservative therapies. Of 55 eligible patients, 21 underwent liposuction (15 arm, 6 leg) and had at least 3 months postsurgical follow-up (85.7 % cancer-related lymphedema). Liposuction was performed under general anesthesia using a published technique, and compression garments were applied intraoperatively and advised to be worn continuously thereafter. Limb volume differences, bioimpedance spectroscopy (L-Dex), and symptom and functional measurements (using the Patient-Specific Functional Scale) were taken presurgery and 4 weeks postsurgery, and then at 3, 6, 9, and 12 months postsurgery. Results. Mean presurgical limb volume difference was 45.1 % (arm 44.2 %; leg 47.3 %). This difference reduced to 3.8 % (arm 3.6 %; leg 4.3 %) by 6 months postsurgery, a mean percentage volume reduction of 89.6 % (arm 90.2 %; leg 88.2 %) [p < 0.001]. All patients had improved symptoms and function. Bioimpedance spectroscopy showed reduced but ongoing extracellular fluid, consistent with the underlying lymphatic pathology. Conclusions. Liposuction is a safe and effective option for carefully selected patients with advanced lymphedema. Assessment, treatment, and follow-up by a multidisciplinary team is essential.
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| 2. |
- Karlsson, Tobias, et al.
(författare)
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Liposuction for Advanced Lymphedema in a Multidisciplinary Team Setting in Australia - Five-Year Follow-Up
- 2023
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Ingår i: Plastic and Reconstructive Surgery. - 0032-1052.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Liposuction for International Society of Lymphology (ISL) late stage II or III 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, Macquarie University.Patients and methods: Between May 2012 and May 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 five-year follow-up.Results: Of the 59 patients, 54 (92%) were women, 30 (51%) had leg lymphedema and 29 (49%) had arm lymphedema. For arm patients, the median preoperative volume difference between the lymphedematous and the contralateral arm was 1061 mL, which reduced to 79 mL one year after surgery and to 22 mL five years after surgery. For leg patients, the median preoperative volume difference was 3447 mL, which reduced to 263 mL one year after surgery but increased to 669 mL five years after surgery.Conclusions: Suction-assisted lipectomy is a long-term option for the management of selected patients with ISL late stage II or III limb lymphedema when conservative management can offer no further improvement.a
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