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A 28-year Single Institutional Experience of Complete Reduction of Extremity Lymphedema Using Suction Assisted Lipectomy.

Brorson, Håkan LU orcid (2023) In Plastic and Reconstructive Surgery - Global Open 11(4S). p.127-128
Abstract (Swedish)
PURPOSE: Absent lymph flow and chronic inflammation
leads to excess subcutaneous adipose tissue deposition.
Chronic non-pitting lymphedema does not respond to conservative
treatment or microsurgical procedures because
they do not target the adipose tissue. Removing the adipose
tissue using suction assisted lipectomy (SAL) seems thus to
be a logic treatment strategy.

METHODS: Arms: 190 women, mean±SEM age of 62±0.8
years, with a duration of arm swelling of 8.6±0.5 years
underwent SAL. Age at breast cancer operation, interval
between breast cancer operation and lymphedema start, and
duration of lymphedema were 51±0.8 years, 2.8±0.4 years,
and 8.6±0.5 years respectively. Legs: 128 patients... (More)
PURPOSE: Absent lymph flow and chronic inflammation
leads to excess subcutaneous adipose tissue deposition.
Chronic non-pitting lymphedema does not respond to conservative
treatment or microsurgical procedures because
they do not target the adipose tissue. Removing the adipose
tissue using suction assisted lipectomy (SAL) seems thus to
be a logic treatment strategy.

METHODS: Arms: 190 women, mean±SEM age of 62±0.8
years, with a duration of arm swelling of 8.6±0.5 years
underwent SAL. Age at breast cancer operation, interval
between breast cancer operation and lymphedema start, and
duration of lymphedema were 51±0.8 years, 2.8±0.4 years,
and 8.6±0.5 years respectively. Legs: 128 patients with a
mean age of 49±1.4 years and with a duration of leg swelling
of 13±0.9 years underwent SAL. There were 64 primary
(PL) and 64 secondary lymphedemas (SL) following cancer
therapy. Age at cancer treatment and interval between cancer
treatment and lymphedema start were 2.5±0.7 years and
42±1.7 years respectively. Age at onset of PL was 10 years.

RESULTS: Arms: Preoperative mean excess volume was
1404±52 ml. Postoperative reduction was 104±2.0% at 3
months and 117±2.1% at 1 year, and more than 100% during
28 years’ follow-up. Legs: Preoperative excess volume
was 3580±153 ml. Postoperative reduction was 82%±2.3%
at 3 months and 101±2.3% at 1 year, and more than 100%
during 23 years’ follow-up.

CONCLUSION: SAL is effective for treatment of chronic
lymphedema in patients who do not respond to conservative
treatment. Removal of the hypertrophied adipose tissue
leads to complete reduction. Constant use of compression
garments maintains outcome. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Plastic and Reconstructive Surgery - Global Open
volume
11
issue
4S
article number
D138
pages
127 - 128
publisher
Lippincott Williams & Wilkins
ISSN
2169-7574
DOI
10.1097/01.GOX.0000935136.65667.c7
language
English
LU publication?
yes
id
8879b7f7-f700-4d6a-bd6c-155bf681f6a6
date added to LUP
2023-07-27 14:47:20
date last changed
2023-07-28 13:32:36
@misc{8879b7f7-f700-4d6a-bd6c-155bf681f6a6,
  abstract     = {{PURPOSE: Absent lymph flow and chronic inflammation<br/>leads to excess subcutaneous adipose tissue deposition.<br/>Chronic non-pitting lymphedema does not respond to conservative<br/>treatment or microsurgical procedures because<br/>they do not target the adipose tissue. Removing the adipose<br/>tissue using suction assisted lipectomy (SAL) seems thus to<br/>be a logic treatment strategy.<br/><br/>METHODS: Arms: 190 women, mean±SEM age of 62±0.8<br/>years, with a duration of arm swelling of 8.6±0.5 years<br/>underwent SAL. Age at breast cancer operation, interval<br/>between breast cancer operation and lymphedema start, and<br/>duration of lymphedema were 51±0.8 years, 2.8±0.4 years,<br/>and 8.6±0.5 years respectively. Legs: 128 patients with a<br/>mean age of 49±1.4 years and with a duration of leg swelling<br/>of 13±0.9 years underwent SAL. There were 64 primary<br/>(PL) and 64 secondary lymphedemas (SL) following cancer<br/>therapy. Age at cancer treatment and interval between cancer<br/>treatment and lymphedema start were 2.5±0.7 years and<br/>42±1.7 years respectively. Age at onset of PL was 10 years.<br/><br/>RESULTS: Arms: Preoperative mean excess volume was<br/>1404±52 ml. Postoperative reduction was 104±2.0% at 3<br/>months and 117±2.1% at 1 year, and more than 100% during<br/>28 years’ follow-up. Legs: Preoperative excess volume<br/>was 3580±153 ml. Postoperative reduction was 82%±2.3%<br/>at 3 months and 101±2.3% at 1 year, and more than 100%<br/>during 23 years’ follow-up.<br/><br/>CONCLUSION: SAL is effective for treatment of chronic<br/>lymphedema in patients who do not respond to conservative<br/>treatment. Removal of the hypertrophied adipose tissue<br/>leads to complete reduction. Constant use of compression<br/>garments maintains outcome.}},
  author       = {{Brorson, Håkan}},
  issn         = {{2169-7574}},
  language     = {{eng}},
  note         = {{Conference Abstract}},
  number       = {{4S}},
  pages        = {{127--128}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Plastic and Reconstructive Surgery - Global Open}},
  title        = {{A 28-year Single Institutional Experience of Complete Reduction of Extremity Lymphedema Using Suction Assisted Lipectomy.}},
  url          = {{https://lup.lub.lu.se/search/files/153591122/2023_Brorson_AAPS.pdf}},
  doi          = {{10.1097/01.GOX.0000935136.65667.c7}},
  volume       = {{11}},
  year         = {{2023}},
}