The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Startseva O.I.

Sechenov First Moscow State Medical University (Sechenov University)

Semenov S.V.

Sechenov First Moscow State Medical University (Sechenov University)

Surgical treatment of lymphedema of the upper extremities in patients with post-mastectomy syndrome

Authors:

Startseva O.I., Semenov S.V.

More about the authors

Read: 2820 times


To cite this article:

Startseva OI, Semenov SV. Surgical treatment of lymphedema of the upper extremities in patients with post-mastectomy syndrome. Plastic Surgery and Aesthetic Medicine. 2023;(4):73‑82. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia202304173

Recommended articles:
Mandible reco­nstruction using the Auto­plan software. Plastic Surgery and Aesthetic Medi­cine. 2024;(4-2):58-65
Modern diagnosis of lymphedema. Plastic Surgery and Aesthetic Medi­cine. 2025;(3-2):104-109
Phle­bolymphedema: Modern Views and Methods of Correction. Journal of Venous Diso­rders. 2024;(4):339-350

References:

  1. Becker C, Vasile JV, Levine JL, Batista BN, Studinger RM, Chen CM, Riquet M. Microlymphatic surgery for the treatment of iatrogenic lymphedema. Clin Plast Surg. 2012;39(4):385-398.  https://doi.org/10.1016/j.cps.2012.08.002
  2. Ivashkov VYu, Denisenko AS, Ushakov AA. Lymphangiosarcoma. Sarkomy kostej, myagkikh tkanej i opukholi kozhi = Bone and Soft Tissue Sarcomas, Tumors of the Skin. 2022;14(2):22-27. (In Russ.). https://doi.org/10.17650/2782-3687-2022-14-2-22-27
  3. DiSipio T, Rye S, Newman B, Hayes S. Incidence of unilateral arm lymphoedema after breast cancer: A systematic review and meta-analysis. Lancet Oncol. 2013;14(6):500-515. Epub 2013 Mar 27. PMID: 23540561. https://doi.org/10.1016/S1470-2045(13)70076-7
  4. Hespe GE, Nores GG, Huang JJ, Mehrara BJ. Pathophysiology of lymphedema-Is there a chance for medication treatment? J Surg Oncol. 2017; 115(1):96-98. Epub 2016 Aug 26. PMID: 27566412. https://doi.org/10.1002/jso.24414
  5. Nguyen TT, Hoskin TL, Habermann EB, Cheville AL, Boughey JC. Breast cancer-related lymphedema risk is related to multidisciplinary treatment and not surgery alone: Results from a large cohort study. Ann Surg Oncol. 2017; 24:2972-2980. https://doi.org/10.1245/s10434-017-5960-x
  6. Brunelle CL, Roberts SA, Shui AM, Gillespie TC, Daniell KM, Naoum GE, Taghian A. Patients who report cording after breast cancer surgery are at higher risk of lymphedema: results from a large prospective screening cohort. J Surg Oncol. 2020;122(2):155-163.  https://doi.org/10.1002/jso.25944
  7. Granzow JW, Soderberg JM, Kaji AH, Dauphine C. Review of current surgical treatments for lymphedema. Ann Surg Oncol. 2014;21(4):1195-1201. Epub 2014 Feb 21. PMID: 24558061. https://doi.org/10.1245/s10434-014-3518-8
  8. Kilbreath SL, Refshauge KM, Beith JM, Ward LC, Ung OA, Dylke ES, French JR, Yee J, Koelmeyer L, Gaitatzis K. Risk factors for lymphoedema in women with breast cancer: A large prospective cohort. Breast. 2016;28:29-36. Epub 2016 May 13. PMID: 27183497. https://doi.org/10.1016/j.breast.2016.04.011
  9. Ribeiro Pereira ACP, Koifman RJ, Bergmann A. Incidence and risk factors of lymphedema after breast cancer treatment: 10 years of follow-up. Breast. 2017;36:67-73. Epub 2017 Oct 6. PMID: 28992556. https://doi.org/10.1016/j.breast.2017.09.006
  10. Földi M, Földi E. Földi’s Textbook of Lymphology. 2011.
  11. Suami H, Taylor GI, Pan WR. The lymphatic territories of the upper limb: anatomical study and clinical implications. Plast Reconstr Surg. 2007;119(6): 1813-1822. PMID: 17440362. https://doi.org/10.1097/01.prs.0000246516.64780.61
  12. Suami H, Kato S. Anatomy of the Lymphatic System and Its Structural Disorders in Lymphoedema. In: Lee BB, Rockson S, Bergan J, eds. Lymphedema. Cham, Switzerland: Springer International Publishing AG; 2018:57-78.  https://doi.org/10.1007/978-3-319-52423-8_5
  13. Kubik S. The role of the lateral upper arm bundle and the lymphatic watersheds in the formation of collateral pathways in lymphedema. Acta Biol Acad Sci Hung. 1980;31:191-200. 
  14. Suami H. Anatomical Theories of the Pathophysiology of Cancer-Related Lymphoedema. Cancers (Basel). 2020;12(5):1338. PMID: 32456209; PMCID: PMC7281515. https://doi.org/10.3390/cancers12051338
  15. Johnson AR, Bravo MG, James TA, Suami H, Lee BT, Singhal D. The All but Forgotten Mascagni-Sappey Pathway: Learning from Immediate Lymphatic Reconstruction. J Reconstr Microsurg. 2019;36:28-31.  https://doi.org/10.1055/s-0039-1694757
  16. Suami H, Scaglioni MF, Dixon KA, Tailor RC. Interaction between vascularized lymph node transfer and recipient lymphatics after lymph node dissection — a pilot study in a canine model. J Surg Res. 2016;204:418-427.  https://doi.org/10.1016/j.jss.2016.05.029
  17. Olszewski W. Pathophysiological and clinical observations of obstructive lymphedema of the limbs. In: Clodius L, ed. Lymphedema. Stuttgar, Germany: Georg Thieme Verlag; 1977:79-102. 
  18. Suami H, Pan W-R, Taylor GI. The lymphatics of the skin filled by a dermal backflow: An observation in a scarred cadaver leg. Lymphology. 2007; 40(3):122-126. 
  19. Chang DW, Suami H. Discussion: Comparison of indocyanine green lymphographic findings with the conditions of collecting lymphatic vessels of limbs in patients with lymphedema. Plast. Reconstr. Surg. 2013;132:1619-1621. https://doi.org/10.1097/PRS.0b013e3182a80798
  20. Chang DW, Suami H, Skoracki R. A prospective analysis of 100 consecutive lymphovenous bypass cases for treatment of extremity lymphedema. Plast Reconstr Surg. 2013;132:1305-1314. https://doi.org/10.1097/PRS.0b013e3182a4d626
  21. Akita S, Nakamura R, Yamamoto N, Tokumoto H, Ishigaki T, Yamaji Y, Sasahara Y, Kubota Y, Mitsukawa N, Satoh K. Early Detection of Lymphatic Disorder and Treatment for Lymphedema following Breast Cancer. Plast Reconstr Surg. 2016;138:192-202.  https://doi.org/10.1097/PRS.0000000000002337
  22. Zampell JC, Aschen S, Weitman ES, Yan A, Elhadad S, De Brot Andrade M, Mehrara BJ. Regulation of adipogenesis by lymphatic fluid stasis: Part I. Adipogenesis, fibrosis, and inflammation. Plast Reconstr Surg. 2012; 129(4):825-834. PMID: 22456354; PMCID: PMC3433726. https://doi.org/10.1097/PRS.0b013e3182450b2d
  23. Brorson H, Ohlin K, Olsson G, Nilsson M. Adipose Tissue Dominates Chronic Arm Lymphedema Following Breast Cancer: An Analysis Using Volume Rendered CT Images. Lymphat Res Biol. 2006;4:199-210.  https://doi.org/10.1089/lrb.2006.4404
  24. Zampell JC, Yan A, Elhadad S, Avraham T, Weitman E, Mehrara BJ. Correction: CD4+ Cells Regulate Fibrosis and Lymphangiogenesis in Response to Lymphatic Fluid Stasis. PLoS One. 2013;8(5). https://doi.org/10.1371/annotation/158f757f-7d51-40b8-a3a4-550811bf0267
  25. Krylov VS, Milanov NO, Abalmasov KG, Sandrikov VA, Sadovnikov VI. Reconstructive microsurgery in treatment of lymphoedema in extremities. Int Angiol. 1985;4:171-175. 
  26. Executive Committee of the International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2020 Consensus Document of the International Society of Lymphology. Lymphology. 2020;53:3-19. 
  27. Pons G, Clavero JA, Alomar X, Rodríguez-Bauza E, Tom LK, Masia J. Preoperative planning of lymphaticovenous anastomosis: The use of magnetic resonance lymphangiography as a complement to indocyanine green lymphography. J Plast Reconstr Aesthet Surg. 2019;72:884-891.  https://doi.org/10.1016/j.bjps.2019.02.024
  28. Ivashkov VYu, Sobolevsky VA, Egorov YuS, Krokhina OV. Diagnosis and reconstructive microsurgery in case of the lymphatic system lesion of the upper limb after mastectomy. Voprosy onkologii. 2018;64(2):211-217. (In Russ.).
  29. Yamamoto T, Narushima M, Doi K, Oshima A, Ogata F, Mihara M, Koshima I, Mundinger GS. Characteristic indocyanine green lymphography findings in lower extremity lymphedema: The generation of a novel lymphedema severity staging system using dermal backflow patterns. Plast Reconstr Surg. 2011;127(5):1979-1986. https://doi.org/10.1097/PRS.0b013e31820cf5df
  30. Charles RH. The surgical technique and operative treatment of elephantiasis of the generative organs based on a series of 140 consecutive successful cases. Indian Medical Gazette. 1901;36:84-99. 
  31. Makhov NI. Otdalennye rezul’taty nalozheniya pryamykh sosudistykh limfovenoznykh anastomozov po povodu slonovosti nizhnej konechnosti. Khirurgiya. 1978;9:72-77. (In Russ.).
  32. Dudnikov AV, Kurochkina OS. History of reconstructive lymphedema surgery. 2017;20(2-61):80-91. (In Russ.).
  33. Yamada Y. The studies on lymphatic venous anastomosis in lymphedema. Nagoya J Med Sci. 1969;32:1-21. 
  34. O’Brien BM, Sykes P, Threlfall GN, Browning FS. Microlymphaticovenous anastomoses for obstructive lymphedema. Plast Reconstr Surg. 1977;60(2): 197-211. 
  35. Abalmasov KG. Khirurgicheskoe lechenie khronicheskikh limfaticheskikh otekov konechnostej i polovykh organov: Diss. ... d-ra med. nauk. M. 1992. (In Russ.).
  36. Allen RJ Jr, Cheng M-H. Lymphedema surgery: Patient selection and an overview of surgical techniques. J Surg Oncol. 2016;113(8):923-931. Epub 2016 Feb 05. PMID: 26846615. https://doi.org/10.1002/jso.24170
  37. Koshima I, Yamamoto T, Narushima M, Mihara M, Iida T. Perforator flaps and supermicrosurgery. Clin Plast Surg. 2010;37(4):683-689, vii-iii. PMID: 20816523. https://doi.org/10.1016/j.cps.2010.06.009
  38. Yamamoto T. Selection of anastomosis type for lymphaticovenular anastomosis. J Plast Reconstr Aesthet Surg. 2013;66(2):207-208. Published: December 05, 2012. https://doi.org/10.1016/j.bjps.2012.11.010
  39. Winters H, Tielemans HJP, Verhulst AC, Paulus VAA, Slater NJ, Ulrich DJO. The long-term patency of lymphaticovenular anastomosis in breast cancer-related lymphedema. Ann Plast Surg. 2019;82:196-200. 
  40. O’Brien BM, Mellow CG, Khazanchi RK, Dvir E, Kumar V, Pederson WC. Long-term results after microlymphaticovenous anastomoses for the treatment of obstructive lymphedema. Plast Reconstr Surg. 1990;85(4):562-572. PMID: 2315396. https://doi.org/10.1097/00006534-199004000-00011
  41. Scaglioni MF, Fontein DBY, Arvanitakis M, Giovanoli P. Systematic review of lymphovenous anastomosis (LVA) for the treatment of lymphedema. Microsurgery. 2017;37(8):947-953. 
  42. Chang DW. Lymphaticovenular bypass for lymphedema management in breast cancer patients: A prospective study. Plast Reconstr Surg. 2010;126(3): 752-758. PMID: 20811210. https://doi.org/10.1097/PRS.0b013e3181e5f6a9
  43. Campisi C, Bellini C, Campisi C, Accogli S, Bonioli E, Boccardo F. Microsurgery for lymphedema: clinical research and long-term results. Microsurgery. 2010;30(4):256-260. PMID: 20235160. https://doi.org/10.1002/micr.20737
  44. Cormier JN, Rourke L, Crosby M, Chang D, Armer J. The surgical treatment of lymphedema: a systematic review of the contemporary literature (2004-2010). Ann Surg Oncol. 2012;19(2):642-651. Epub 2011 Aug 24. PMID: 21863361. https://doi.org/10.1245/s10434-011-2017-4
  45. Ivashkov VYu. Vascularized lymph node transplantation in the treatment of hand lymphedema. Anatomic study of inguinal lymph flap. The technique of double staining of lymph nodes. Sarkomy kostej, myagkikh tkanej i opukholi kozhi = Bone and Soft Tissue Sarcomas, Tumors of the Skin. 2016;2:61-66. (In Russ.).
  46. Egorov YuS, Burkov IV, Abalmasov KG, Bystrov AA, Kurov EA. Primenenie svobodnoj peresadki bol’shogo sal’nika s tsel’yu sozdaniya drenazha limfy pri pervichnom limfostaze u detej. Problemy mikrokhirurgii. 1989;3:145-146. (In Russ.).
  47. Chang EI, Masià J, Smith ML. Combining Autologous Breast Reconstruction and Vascularized Lymph Node Transfer. Semin Plast Surg. 2018;32(1): 36-41. 
  48. Becker C, Assouad J, Riquet M, Hidden G. Postmastectomy lymphedema: long-term results following microsurgical lymph node transplantation. Ann Surg. 2006;243(3):313-315. 
  49. Ward J, King I, Monroy-Iglesias M, Russell B, van Hemelrijck M, Ramsey K, Khan AA. A meta-analysis of the efficacy of vascularised lymph node transfer in reducing limb volume and cellulitis episodes in patients with cancer treatment-related lymphoedema. Eur J Cancer. 2021;151:233-244. 
  50. Ivashkov VYu, Sobolevsky VA, Egorov YuS. Modern aspects of surgical treatment of upper limb lymphedema in patients after combined treatment of breast cancer. Sarkomy kostej, myagkikh tkanej i opukholi kozhi = Bone and Soft Tissue Sarcomas, Tumors of the Skin. 2016;1:70-75. (In Russ.).
  51. Schaverien MV, Chang EI. Combined deep inferior epigastric artery perforator flap with vascularized groin lymph node transplant for treatment of breast cancer-related lymphedema. Gland Surg. 2021;10(1):460-468. 
  52. Akita S, Tokumoto H, Yamaji Y, Sasahara Y, Kubota Y, Kubo M, Kuriyama M, Mitsukawa N. Contribution of Simultaneous Breast Reconstruction by Deep Inferior Epigastric Artery Perforator Flap to the Efficacy of Vascularized Lymph Node Transfer in Patients with Breast Cancer-Related Lymphedema. J Reconstr Microsurg. 2017;33(8):571-578. 
  53. Maldonado AA, Chen R, Chang DW. The use of supraclavicular free flap with vascularized lymph node transfer for treatment of lymphedema: A prospective study of 100 consecutive cases. J Surg Oncol. 2017 Jan;115(1):68-71. Epub 2016 July 22. Erratum in: J Surg Oncol. 2018;118(4):721.  https://doi.org/10.1002/jso.24351
  54. Brorson H. Liposuction in arm lymphedema treatment. Scand J Surg. 2003; 92(4):287-295. 
  55. Brorson H. Complete reduction of arm lymphedema following breast cancer — a prospective twenty-one years’ study Plast Reconstr Surg. 2015; 136(4 Suppl):134-135. 
  56. Brorson H, Svensson H. Liposuction combined with controlled compression therapy reduces arm lymphedema more effectively than controlled compression therapy alone. Plast Reconstr Surg. 1998;102(4):1058-1067, discussion 1068.
  57. Lee D, Piller N, Hoffner M, Manjer J, Brorson H. Liposuction of Postmastectomy Arm Lymphedema Decreases the Incidence of Erysipelas. Lymphology. 2016;49(2):85-92. 
  58. Brorson H. Liposuction in arm lymphedema treatment. Scand J Surg. 2003; 92(4):287-295. 
  59. Boyages J, Kastanias K, Koelmeyer LA, Winch CJ, Lam TC, Sherman KA, Munnoch DA, Brorson H, Ngo QD, Heydon-White A, Magnussen JS, Mackie H. Liposuction for Advanced Lymphedema: A Multidisciplinary Approach for Complete Reduction of Arm and Leg Swelling. Ann Surg Oncol. 2015;22(suppl 3):1263-1270. https://doi.org/10.1245/s10434-015-4700-3
  60. Leppäpuska IM, Suominen E, Viitanen T, Rannikko E, Visuri M, Mäki M, Saarikko A, Hartiala P. Combined Surgical Treatment for Chronic Upper Extremity Lymphedema Patients: Simultaneous Lymph Node Transfer and Liposuction. Ann Plast Surg. 2019;83(3):308-317. PMID: 31008792. https://doi.org/10.1097/SAP.0000000000001828

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.