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Br J Nurs 2021 May;30(9):S18-S26

National Lymphoedema Research Specialist, Lymphoedema Network Wales.

Background: Adults and children report genital oedema but prevalence is unknown. Pre-registration nurse training rarely includes genital oedema and postgraduate training opportunities are rare.

Aim: To identify the education needs of health professionals regarding management of genital oedema. Read More

Ann Plast Surg 2021 May;86(5S Suppl 3):S384-S389

From the Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, CA.

Introduction: Outcomes of surgical lymphedema treatment are currently suboptimal. Physiologic procedures including lymphovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT) reestablish lymphatic flow but cannot correct fibroadipose deposition, whereas liposuction alone cannot prevent disease progression. We propose a treatment algorithm combining liposuction with LVA or VLNT that can achieve normal limb volumes and prevent disease progression in stage II-III lymphedema. Read More

Acta Med Port 2021 Mar 1;34(3):217-228. Epub 2021 Mar 1.

Serviço de Dermatovenereologia. Centro Hospitalar e Universitário do Porto. Porto. Departamento de Dermatovenereologia. Instituto de Ciências Biomédicas Abel Salazar. Porto. Portugal.

Non-necrotizing acute dermo-hypodermal infections are infectious processes that include erysipela and infectious cellulitis, and are mainly caused by group A β-haemolytic streptococcus. The lower limbs are affected in more than 80% of cases and the risk factors are disruption of cutaneous barrier, lymphoedema and obesity. Diagnosis is clinical and in a typical setting we observe an acute inflammatory plaque with fever, lymphangitis, adenopathy and leucocytosis. Read More

Lymphat Res Biol 2021 May 10. Epub 2021 May 10.

Department of Rehabilitation Medicine and College of Medicine, Chungnam National University, Daejeon, South Korea.

This study aimed at understanding the trend in extracellular fluid (ECF) change and estimating the efficacy of the early complex decongestive therapy (CDT) program in terms of prevalence of lower limb lymphedema, as well as at identifying the quality of life (QoL) associated with response to CDT after gynecological cancer therapy. Thirty-one patients undergoing gynecological cancer treatment were enrolled and randomly assigned to the CDT and control groups. In the CDT group, CDT was started within 2 weeks after surgery for 30 minutes a day, for 2 weeks (5 days per week). Read More

Indian J Dermatol Venereol Leprol 2021 Apr 23:1-3. Epub 2021 Apr 23.

Department of Dermatology, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain.

Gland Surg 2021 Apr;10(4):1447-1459

Department of Breast Disease, Henan Breast Cancer Center, The affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.

Background: Here, we carried out an extensive meta-analysis to investigate the effectiveness of the use of axillary reverse mapping (ARM) during axillary lymph node dissection (ALND) in preventing breast cancer-related lymphedema (BCRL).

Methods: Database searches to identify relevant randomized controlled trials (RCTs) were performed of MEDLINE (PubMed), Web of Science, Embase, and the Cochrane Library. Eligible articles with a publication date from database establishment to December 2020 were retrieved by combining keywords including: "breast cancer", "breast carcinoma", "breast neoplasm", "axillary reverse mapping", "axillary lymph node dissection", "lymphatic arm drainage", and "lymphedema". Read More

Plast Reconstr Surg Glob Open 2021 Mar 22;9(3):e3509. Epub 2021 Mar 22.

Department of Plastic, Reconstructive and Aesthetic Surgery, Gent University Hospital, Gent, Belgium.

Background: Lymphedema is defined as a chronic condition, caused by lymphostasis. A major part in the Western world consists of iatrogenic lymphedema caused by surgery to the lymph nodes of the axilla or groin. Prophylactic lymphovenous anastomosis (LVA) could be beneficial in the prevention of lymphedema of the extremities. Read More

Plast Reconstr Surg Glob Open 2021 Mar 22;9(3):e3490. Epub 2021 Mar 22.

Department of Lymphatic and Reconstructive Surgery, JR Tokyo General Hospital, Tokyo, Japan.

Recently, there has been a growing interest in the use of lymphatic ultrasound in the preoperative investigation of lymphaticovenous anastomosis. The device used for the performance of lymphatic ultrasound varies among surgeons. In this case report, we compared several probes (18 MHz, 24 MHz, and 33 MHz linear probes) in 2 cases, to detect the lymphatic vessels in the lymphedematous limbs. Read More

Plast Reconstr Surg Glob Open 2021 Mar 22;9(3):e3476. Epub 2021 Mar 22.

International Center for Lymphoedema, Hiroshima University Hospital, Japan.

Infect Dis Poverty 2021 May 7;10(1):64. Epub 2021 May 7.

AIM Initiative-American Leprosy Missions, Greenville, SC, USA.

Background: The Upper West region of Ghana is mostly made up of rural communities and is highly endemic for lymphatic filariasis (LF), with a significant burden of disability due to lymphedema and hydrocele. The aim of this paper is to describe an enhanced, evidence-based cascading training program for integrated lymphedema management in this region, and to present some initial outcomes.

Main Text: A baseline evaluation in the Upper West Region was carried out in 2019. Read More

Am J Case Rep 2021 May 7;22:e930306. Epub 2021 May 7.

Private Practice, Karen L. Herbst, MD, PC, Los Angeles, CA, USA.

BACKGROUND Lipedema is a common condition that presents as excessive fat deposition in the extremities, initially sparing the trunk, ankles, and feet, and is found mainly in women, usually occurring after puberty or pregnancy. Lipedema can progress to include lipo-lymphedema of the ankles and feet. This report is of a 41-year old woman with Stage 3 lipedema and lipo-lymphedema with excessive fat of the lower body since puberty, with progression to swollen ankles and feet despite dietary caloric restriction. Read More

J Vasc Surg Venous Lymphat Disord 2021 May 3. Epub 2021 May 3.

Department of Dermatology, Centre Hospitalier Universitaire de Rennes, Rennes; EA 7449 REPERES (Pharmacoepidemiology and Health Services Research), Rennes 1 University, Rennes, France.

Background: Limb lymphedema is a chronic disease with primary and secondary forms, the latter essentially after cancer treatment.

Objectives: To analyze retrospectively cellulitis frequency and its associated risk factors in patients with primary or secondary limb lymphedema.

Methods: Information from all 1,991 patients referred to a specialized lymphedema center, from January to June 2018, was collected: previous cellulitis episode(s), clinical and lymphedema characteristics. Read More

Int Wound J 2021 May 5. Epub 2021 May 5.

Department of Plastic, and Aesthetic, Reconstructive and Hand Surgery, AGAPLESION Markus Hospital, Frankfurt am Main, Germany.

This study examined the disease-specific quality of life (QoL) in lipoedema patients undergoing treatment for the condition with liposuction. We conducted a retrospective analysis of all patients (n = 69) who underwent liposuction for treatment of lipoedema between 2004 and 2019, and gathered data on patient age, body mass index, the number of liposuction sessions, and the amount of fat removed per side. The study also prospectively evaluated the QoL in 20 lipoedema patients before and after liposuction using the Freiburg Life Quality Assessment for lymphatic diseases questionnaire. Read More

World J Transplant 2021 Apr;11(4):129-137

Division of Plastic Surgery, Department for Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Goettingen, Goettingen 37075, Lower Saxony, Germany.

Background: Secondary lymphedema after surgical interventions is a progressive, chronic disease that is still not completely curable. Over the past years, a multitude of surgical therapy options have been described.

Aim: To summarize the single-center complications in lymph vessel (LVTx) and free vascularized lymph node transfer (VLNT). Read More

PeerJ 2021 13;9:e11252. Epub 2021 Apr 13.

Faculty of Physical Therapy, Basic Science Department, Cairo University, Cairo, Egypt.

Background: Breast cancer related upper limb lymphedema (BCRL) is a common complication in post-mastectomy patients. It is known to cause upper limb disability, which subsequently may affect the grip strength and hand function. There is little evidence on the objective assessment of functional activities particularly hand function in women with BCRL. Read More

Chin Clin Oncol 2021 Apr;10(2):18

Breast, Gynecology and Reconstructive Surgery Unit, Institut Curie, Paris, France.

In early-stage cervical cancer, lymph node status is of paramount importance to determine the best therapeutic strategy and is one of the most important prognostic factors of survival. According to main international guidelines, pelvic full lymphadenectomy is recommended for lymph node staging. Sentinel lymph node (SLN) biopsy is an accurate method for the assessment of lymph nodal involvement and has been suggested instead of systematic pelvic lymph node dissection (PLND). Read More

Clin Exp Metastasis 2021 May 5. Epub 2021 May 5.

Division of Plastic Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA, USA.

This manuscript is a summary of findings focusing on various aspects of secondary lymphedema specifically as a sequelae of treatment for cancer. The topic was addressed at a session held during the 8th International Congress on Cancer Metastasis that was unique a for the inclusion of patients with lymphedema and therapists joining physicians, healthcare professionals, and researchers in an effort to give an overview of secondary lymphedema following cancer therapy as well as highlighting the unknowns in the field. Lymphedema is defined and both diagnosis and incidence of cancer-related lymphedema are explored. Read More

J Community Health Nurs 2021 Apr-Jun;38(2):130-138

Department of Physical Medicine and Rehabilitation, Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey.

The purpose of this study is to investigate the effects of post-mastectomy lymphedema on balance, kinesiophobia and fear of falling. A cross-sectional study with a control group. Seventy patients and 62 healthy volunteers were included. Read More

Turk J Phys Med Rehabil 2021 Mar 4;67(1):56-61. Epub 2021 Mar 4.

Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

Objectives: In this study, we aimed to investigate the availability of the Timed Up and Go (TUG) test in daily practice instead of the Tampa Scale for Kinesiophobia (TSK) test for the evaluation of fear of movement and to assess the functionality of the upper extremity in postmastectomy lymphedema patients.

Patients And Methods: Between March 2018 and July 2018, a total of 30 female patients (mean age 53.8±12. Read More

Oncol Res Treat 2021 May 4:1-10. Epub 2021 May 4.

Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.

Introduction: Angiosarcoma (AS) is a rare subtype of soft tissue sarcoma. We performed a retrospective analysis of patient characteristics, treatments and prognostic factors in patients treated in a single sarcoma center.

Methods: We reviewed records of patients treated between 1987 and 2018, categorized in 7 different subtypes according to tissue of origin and underlying risk factors. Read More

Clin Rehabil 2021 May 3:2692155211014100. Epub 2021 May 3.

Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium.

Actas Dermosifiliogr 2021 Apr 30. Epub 2021 Apr 30.

Servicio Dermatología Hospital Son Espases, Palma, Illes Balears, España.

J Trop Med 2021 15;2021:5551637. Epub 2021 Apr 15.

Department of Biology, College of Natural and Computational Sciences, Wollega University, Nekemte, Ethiopia.

Elephantiasis is the main cause of tropical lymphoedema in Ethiopia. The aim of the current study was to assess the etiology of elephantiasis and its associated risk factors. Cross-sectional community-based study was carried out from March to May 2020 in seven purposively selected villages of Jeldu district. Read More

Support Care Cancer 2021 Apr 29. Epub 2021 Apr 29.

Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan.

Purpose: Although regarded as an important treatment for lymphedema, the therapeutic effects of active exercise with compression therapy (AECT) are supported by little evidence. The purpose of this study was to determine the relative benefits of AECT with different postures for patients with lower limb lymphedema (LLL).

Methods: Eighteen women with LLL secondary to surgical treatment of gynecological cancer, completed (1) AECT in a seated position (seated AECT), (2) AECT in a supine position (supine AECT), and (3) compression-only therapy in a supine position (CT) in this randomized, controlled, crossover trial. Read More

Cancers (Basel) 2021 Apr 27;13(9). Epub 2021 Apr 27.

Department of Radiation Oncology, University Hospital Muenster, 48149 Munster, Germany.

Radiation therapy (RT) for extremity soft tissue sarcoma is associated with lymphedema risk. In this study, we analyzed the influence of lymph-sparing volume on the lymphedema occurrence in patients who received adjuvant extremity RT. The lymph-sparing quotient (LSQ) was calculated by dividing the lymph-sparing volume by the total extremity volume with double weightingfor the narrowest lymph-sparing region. Read More

Genes (Basel) 2021 Apr 27;12(5). Epub 2021 Apr 27.

MAGI'S Lab, 38068 Rovereto, Italy.

Forkhead-box C2 (FOXC2) is a transcription factor involved in lymphatic system development. mutations cause Lymphedema-distichiasis syndrome (LD). Recently, a natural antisense was identified, called lncRNA FOXC2-AS1, which increases mRNA stability. Read More

Cells 2021 Apr 24;10(5). Epub 2021 Apr 24.

Department of Anatomy and Cell Biology, University Medical School Göttingen, 37075 Göttingen, Germany.

Lymphedema (LE) affects millions of people worldwide. It is a chronic progressive disease with massive development of fibrosclerosis when untreated. There is no pharmacological treatment of lymphedema. Read More

Int J Mol Sci 2021 Apr 24;22(9). Epub 2021 Apr 24.

Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, USA.

The mechanisms of lymphedema development are not well understood, but emerging evidence highlights the crucial role the immune system plays in driving its progression. It is well known that lymphatic function deteriorates as lymphedema progresses; however, the connection between this progressive loss of function and the immune-driven changes that characterize the disease has not been well established. In this study, we assess changes in leukocyte populations in lymph nodes within the lymphatic drainage basin of the tissue injury site (draining lymph nodes, dLNs) using a mouse tail model of lymphedema in which a pair of draining collecting vessels are left intact. Read More

Int J Mol Sci 2021 Apr 12;22(8). Epub 2021 Apr 12.

Department of Physiology, Semmelweis University School of Medicine, 1094 Budapest, Hungary.

Our understanding of the function and development of the lymphatic system is expanding rapidly due to the identification of specific molecular markers and the availability of novel genetic approaches. In connection, it has been demonstrated that mechanical forces contribute to the endothelial cell fate commitment and play a critical role in influencing lymphatic endothelial cell shape and alignment by promoting sprouting, development, maturation of the lymphatic network, and coordinating lymphatic valve morphogenesis and the stabilization of lymphatic valves. However, the mechanosignaling and mechanotransduction pathways involved in these processes are poorly understood. Read More

Healthcare (Basel) 2021 Apr 15;9(4). Epub 2021 Apr 15.

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu 42415, Korea.

This study aimed to determine whether bypass circulation was present in lymphedema and its effect. This was a retrospective, cross-sectional study. Patients who underwent unilateral breast cancer surgery with axillary lymph node dissection were recruited and underwent single-photon emission tomography/computed tomography (SPECT/CT). Read More