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Clinical Management of Lymphedema
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Clinical Management of Lymphedema

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine".

Deadline for manuscript submissions: closed (15 June 2022) | Viewed by 4088

Special Issue Editor

Prof. Dr. Nobuyuki Mitsukawa

E-Mail Website
Guest Editor
Department of Plastic, Reconstructive and Aesthetic Surgery, Chiba, Japan
Interests: Reconstructive Surgery of the whole body, including head and neck, breast, limbs with lymphatic disorders, and Aesthetic surgery.

Special Issue Information

Dear Colleagues,

Lymphedema is a disease that seriously impairs patients' quality of life and is once considered challenging to treat. In recent years, various diagnostic modalities and treatment methods have been developed, resulting in a dramatic improvement in treatment outcomes. Lymphedema management includes prevention, early detection, severity assessment, treatment strategy, treatment modality, post-treatment assessment, and long-term effect. Neither phase has been fully standardized, and there is room for more new strategies to be attempted. There are also many issues that need to be examined for methods that have already been recognized as beneficial. Clinical management requires the accumulation of evidence in all aspects, including the comparison of each method and the effects of combining multiple procedures.

In this Special Issue of the Journal of Clinical Medicine on Clinical Management of Lymphedema, we invite authors to submit their original papers and share their innovative and novel ideas, techniques, and strategies in this field of interest. Review articles are welcome to summarize the established treatment methods.

Prof. Dr. Nobuyuki Mitsukawa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • lymphedema
  • diagnosis
  • surgical treatment
  • lymphaticovenular anastomosis
  • vascularized lymph node transfer
  • liposuction
  • conservative treatment
  • clinical management
 
 

Published Papers (3 papers)

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Research

12 pages, 3038 KiB  
Article
Clinical and Histological Effects of Partial Blood Flow Impairment in Vascularized Lymph Node Transfer
by Shinsuke Akita, Yuzuru Ikehara, Minami Arai, Hideki Tokumoto, Yoshihisa Yamaji, Kazuhiko Azuma, Yoshitaka Kubota, Hideaki Haneishi, Motoko Y. Kimura and Nobuyuki Mitsukawa
J. Clin. Med. 2022, 11(14), 4052; https://doi.org/10.3390/jcm11144052 - 13 Jul 2022
Viewed by 1310
Abstract
Regarding vascularized lymph node transfer (VLNT) for lymphedema, partial blood flow impairment in transferred lymph node (LN) flaps may adversely affect the therapeutic results. We investigated the clinical and histological effects of partial blood flow impairment in LN flaps. In upper extremity lymphedema [...] Read more.
Regarding vascularized lymph node transfer (VLNT) for lymphedema, partial blood flow impairment in transferred lymph node (LN) flaps may adversely affect the therapeutic results. We investigated the clinical and histological effects of partial blood flow impairment in LN flaps. In upper extremity lymphedema cases, based on ultrasonographic examination at 2 weeks after VLNT, we compared the treatment results depending on whether the postoperative blood flow in transferred LNs was good (Group G) or poor (Group P). Novel partial ischemia and congestion of LN flap mouse models were developed to determine their histological features. In 42 cases, significant differences were observed between Group G (n = 37) and Group P (n = 5) based on the amount of volume reduction (136.7 ± 91.7 mL and 55.4 ± 60.4 mL, respectively; p = 0.04) and lymph flow recanalization rate in indocyanine green fluorescent lymphography (67.6% and 0%, respectively; p = 0.0007). In mouse models, thrombi formation in the marginal sinus and numerous Myl9/12-positive immunocompetent cells in follicles were observed in congested LNs. Blood flow maintenance in the transferred LNs is an essential factor influencing the therapeutic effect of VLNT. Postoperatively, surgeons should closely monitor blood flow in the transferred LNs, particularly in cases of congestion. Full article
(This article belongs to the Special Issue Clinical Management of Lymphedema)
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11 pages, 876 KiB  
Article
Lymphaticovenous Anastomosis for Treating Secondary Lower Limb Lymphedema in Older Patients—A Retrospective Cohort Study
by Johnson Chia-Shen Yang, Yu-Ming Wang, Shao-Chun Wu, Wei-Che Lin, Peng-Chen Chien, Pei-Yu Tsai, Ching-Hua Hsieh and Sheng-Dean Luo
J. Clin. Med. 2022, 11(11), 3089; https://doi.org/10.3390/jcm11113089 - 30 May 2022
Cited by 1 | Viewed by 1714
Abstract
Despite an increased incidence of secondary lower limb lymphedema (LLL) and severity of comorbidities with age, the impact of age on the effectiveness of lymphaticovenous anastomosis (LVA) in the older patients remains unclear. Methods: This retrospective cohort study enrolled older patients (age > [...] Read more.
Despite an increased incidence of secondary lower limb lymphedema (LLL) and severity of comorbidities with age, the impact of age on the effectiveness of lymphaticovenous anastomosis (LVA) in the older patients remains unclear. Methods: This retrospective cohort study enrolled older patients (age > 65 years) with secondary unilateral LLL. All patients underwent supermicrosurgical LVA. Demographic data and intraoperative findings including lymphatic vessel (LV) diameter, LV functionality (indocyanine green-enhanced and Flow positivity), and lymphosclerosis classification were recorded. Magnetic resonance volumetry was used for measuring preoperative and postoperative volume changes at 6 months and one year after LVA as primary and secondary endpoints. Results: Thirty-two patients (29 females/3 males) with a median age of 71.0 years [range, 68.0 to 76.3] were enrolled. The median duration of lymphedema was 6.4 [1.0 to 11.7] years. The median LV diameter was 0.7 [0.5 to 0.8] mm. The percentage of ICG-enhanced and Flow-positive LVs were 89.5% and 85.8%, respectively. The total percentage of suitable LVs (s0 and s1) for LVA based on lymphosclerosis classification was 75.9%. There were significant six-month and one-year post-LVA percentage volume reductions compared to pre-LVA volume (both p < 0.001). A significant reduction in cellulitis incidence was also noted after LVA (p < 0.001). No surgical or postoperative complications were found. Conclusion: Relief of secondary LLL was achievable through LVA in older patients who still possessed favorable LV characteristics, including larger LV diameters as well as a high proportion of functional LVs with a low grade of lymphosclerosis. Full article
(This article belongs to the Special Issue Clinical Management of Lymphedema)
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7 pages, 745 KiB  
Article
Evaluation of the External Jugular Vein Overlying the Sternocleidomastoid Muscle as Venous Lymph-Node Flap
by Lorenz Kadletz-Wanke, Felicitas Oberndorfer, Erik Grabner, Lukas Kenner, Klaus F. Schrögendorfer and Gregor Heiduschka
J. Clin. Med. 2022, 11(7), 1812; https://doi.org/10.3390/jcm11071812 - 25 Mar 2022
Cited by 1 | Viewed by 1863
Abstract
Background: Until recently, vascularized lymph-node flaps were based on arterial and venous donor vessels. Now, venous lymph-node flaps form a novel promising concept in the treatment of advanced-stage lymphedema. In preliminary studies, the external jugular vein has shown promising results as a venous [...] Read more.
Background: Until recently, vascularized lymph-node flaps were based on arterial and venous donor vessels. Now, venous lymph-node flaps form a novel promising concept in the treatment of advanced-stage lymphedema. In preliminary studies, the external jugular vein has shown promising results as a venous lymph-node flap. However, nothing is known about the number of lymph nodes adjacent to the external jugular vein. Methods: Standardized specimens of the external jugular vein and surrounding fatty tissue directly overlying the sternocleidomastoid muscle were obtained during routine neck dissection. Histologic evaluation was performed in order to evaluate for the presence of lymph nodes within the tissue. Results: A total of 20 specimens were evaluated. There was no vein in 4 of the samples. We found lymph nodes in 9 of the remaining 16 samples. In 7 samples, lymph nodes were absent. Conclusion: Our results suggest that the vein directly overlying the sternocleidomastoid muscle may not be the ideal candidate for a venous lymph-node flap. Full article
(This article belongs to the Special Issue Clinical Management of Lymphedema)
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