Campisi C, Boccardo F, Casaccia M.
[Post-mastectomy lymphedema: surgical therapy]
Ann Ital Chir. 2002 Sep-Oct;73(5):473-8. Italian.
Dipartimento di Scienze Chirurgiche Specialistiche, Anestesiologia e
Trapianti d'Organo (DISCAT), Sezione di Clinica Chirurgica d'Urgenza, Centro
di Linfologia e Microchirurgia, Ospedale S. Martino, Universita
degli Studi di Genova. campisi@unige.
it After some preliminary remarks concerning epidemiological data about
post-mastectomy lymphedema, on the basis of specific etiologic and
pathophysiologic aspects, authors report a modern clinical and instrumental
staging of lymphedema and an accurate diagnostic protocol,
which allows not only to study lymphedema at late stages, but
also to individuate the disease at earliest stages. Protocols of
medical, physical and rehabilitative treatment mostly used today are
schematically described, and they include proper igienic measures for the
prevention bacterial and micotic infections, manual lymph drainage,
sequential compression therapy, exercises, thermotherapy,
bandages and elastic garments. Authors underline above all the importance of
Microsurgery in treating post-mastectomy lymphedema, by means of
modern methods of lymphatic microsurgery, derivative or reconstructive
(multiple lymphatic-venous anastomoses, lymphatic-venous-lymphatic plasty).
The operation of multiple lymphatic-venous anastomoses
represent the mostly used technique. The registry consists of 194
microsurgical operations, performed in patients treated and followed-up
statistically in the last 15 years, with positive result in over 80% of cases.