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Gabriele G, Nigri A, Chisci G, Massarelli O, Cascino F, Komorowska-Timek E, Kazuki K, Hara H, Mihara M, Gennaro P. Combination of Supramicrosurgical Lymphatico-Venular Anastomosis (sLVA) and Lymph-Sparing Liposuction in Treating Cancer-Related Lymphedema: Rationale for a Regional One-Stage Approach. J Clin Med 2024; 13:2872. [PMID: 38792415 PMCID: PMC11121812 DOI: 10.3390/jcm13102872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/06/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Objective: Cancer-related lymphedema represents a potential complication of cancer treatment. The aim of this study is to evaluate the effectiveness of the combination of lymphatico-venular anastomosis and liposuction in the treatment of secondary lymphedema. Methods: We present a retrospective analysis of patients affected by cancer-related unilateral limb lymphedema. Inclusion criteria included previous neoplastic pathology with the consequent development of unilateral limb lymphedema, while the exclusion criteria included the presence of comorbidities and the persistence of cancer, as well as previous lymphatic surgery. The outcomes to be included were a reduction in the limb volume and lymphangitis rate, and an improvement in the quality of life. Patients' data were assessed before surgery and 1 year after surgery. Perioperative management included clinical and ultrasonographical evaluations. Under local anesthesia, lymphatico-venular anastomosis with the supramicrosurgical technique and the liposuction of the affected limb was performed in the same surgical session. Results: A total of 24 patients were enrolled in the study. One year after the surgery, an average volume reduction of 37.9% was registered (p = 0.0000000596). The lymphangitis rate decreased after surgery from 4.67 to 0.95 per year (p = 0.000007899). The quality-of-life score improved from 68.7 to 16 according to the LLIS scale. Conclusions: The combination of LVA and liposuction represents a valid strategy for treating cancer-related lymphedema, ensuring stable results over time. In addition, it can be performed under local anesthesia, resulting in being minimally invasive and well-tolerated by patients. This paper reports on the short-term efficacy of this combined technique.
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Affiliation(s)
- Guido Gabriele
- Department of Maxillo-Facial Surgery, Faculty of Medicine and Surgery, University of Siena, 53100 Siena, Italy; (O.M.); (F.C.); (P.G.)
| | - Andrea Nigri
- Department of Economics, Management and Territory, University of Foggia, 71122 Foggia, Italy;
| | - Glauco Chisci
- Oral Surgery School, Department of Medical Biotechnologies, University of Siena, Via Ricasoli 18, 58100 Grosseto, Italy
| | - Olindo Massarelli
- Department of Maxillo-Facial Surgery, Faculty of Medicine and Surgery, University of Siena, 53100 Siena, Italy; (O.M.); (F.C.); (P.G.)
| | - Flavia Cascino
- Department of Maxillo-Facial Surgery, Faculty of Medicine and Surgery, University of Siena, 53100 Siena, Italy; (O.M.); (F.C.); (P.G.)
| | - Ewa Komorowska-Timek
- Advanced Plastic Surgery, Michigan State University, East Lansing, MI 48502, USA;
| | - Kikuchi Kazuki
- Department of Plastic Surgery, Nadogaya Hospital, 2-1-1 Shinkasiwa, Kashiwa 277-0084, Japan; (K.K.); (H.H.); (M.M.)
| | - Hisako Hara
- Department of Plastic Surgery, Nadogaya Hospital, 2-1-1 Shinkasiwa, Kashiwa 277-0084, Japan; (K.K.); (H.H.); (M.M.)
| | - Makoto Mihara
- Department of Plastic Surgery, Nadogaya Hospital, 2-1-1 Shinkasiwa, Kashiwa 277-0084, Japan; (K.K.); (H.H.); (M.M.)
| | - Paolo Gennaro
- Department of Maxillo-Facial Surgery, Faculty of Medicine and Surgery, University of Siena, 53100 Siena, Italy; (O.M.); (F.C.); (P.G.)
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Blei F. Update December 2023. Lymphat Res Biol 2023; 21:614-640. [PMID: 38149917 DOI: 10.1089/lrb.2023.29154.fb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023] Open
Affiliation(s)
- Francine Blei
- Hassenfeld Children's Hospital at NYU Langone, The Laurence D. and Lori Weider Fink Children's Ambulatory Care Center, New York, New York, USA
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