[Lymphology in 2002. From diagnosis to treatment of lymphedemas]

[In search of the ideal surgical treatment for lymphedema. Report of 2nd European Conference on supermicrosurgery (Barcelona - March 2012)]

Since more than 50 years, many surgeons all around the world try to find the perfect surgical technique to treat limb lymphedemas. Decongestive physiotherapy associated with the use of a compressive garment has been the primary choice for lymphedema treatment. Many different surgical techniques have been developed, however, to date, there is no consensus on surgical procedure. Most surgical experts of lymphedema met in the second European Conference on supermicrosurgery, organized on March 1st and 2nd 2012, in San Pau Hospital, Barcelona. Together they tried to clarify these different options and ideally a strategy for using these techniques.

A newly designed SIPC device for management of lymphoedema

PURPOSE

Using (Sequential) intermittent pneumatic compression (SIPC) is one of the most appropriate nonsurgical treatments for lymphoedema. In this study, we introduce a new mode for SIPC and evaluate its clinical results with higher pressures.

METHODS

Participants included 43 lower limb lymphoedema patients who underwent high pressure SIPC. Limb circumference pre- and post-SIPC were evaluated.

RESULTS

The mean reduction of the affected limb oedema was approximately 75%, which is regarded as a good response to the short-term treatment. Patients with disease duration more than 20 years didn't show a good or excellent response. Also the foot area had the least degree of reduction of oedema.

CONCLUSION

We concluded that, the suggested mode may provide more acceptable results compared with the other This mode allows unidirectional forward lymph flow and associated high pressure usage well tolerated in chronic cases of the disease.

Palliative und supportive Therapie bei Patienten mit fortgeschrittenem Prostatakarzinom

In patients with advanced prostate cancer, quality of life and prevention of complications come to the fore. Besides handling local complications such as obstruction, hematuria and lymphedema, treatment of bone metastases and their complications is of great importance. Analgesic measures, bisphosphonates, radiation therapy, radionuclide therapy and neurosurgical procedures are available. Spinal cord compression with acute motor and sensory deficiency requires immediate neurosurgical and/or radiation therapy. Tumor anemia should be treated appropriately.