Pediatric lymphedema and correlated syndromes: role of microsurgery.

Authors report modern diagnostic and therapeutic procedures used in the correct assessment and treatment of congenital lymphatic and chylous disorders. Lymphatic dysplasias can be clinically represented only by peripheral lymphedema or be associated with more complex dysfunctions of chyliferous vessels and the thoracic duct (chylous ascitis, chylothorax, etc.) It is, therefore, useful to perform a complete diagnostic evaluation of each patient before carrying out any therapeutical approach.

The lymphatics in the pathophysiology of thoracic and abdominal surgical pathology: immunological consequences and the unexpected role of microsurgery.

The authors report their experience in the diagnosis and treatment of lymphatic and chylous disorders in the thoracic and abdominal areas. Sixteen patients (10 adults, 6 children) affected by primary chylous ascites with associated syndromes and consequent immunological incompetence were studied. Diagnostic investigations included abdominal sonography scans, lymphoscintigraphy, and lymphography combined with computed tomography and laparoscopy.

Microsurgery for treatment of peripheral lymphedema: long-term outcome and future perspectives.

Authors report over 30 years of their own clinical experience in the treatment of chronic peripheral lymphedemas by microsurgical techniques performed at the Center of Lymphatic Surgery of the University of Genoa, Italy. Over 1,500 lymphedema patients were treated with microsurgical techniques. Derivative lymphatic-venous techniques were most often used.

Diagnosis and management of primary chylous ascites.

Background: Chylous ascites is the accumulation of triglyceride-rich, free, milk-like peritoneal fluid caused by the presence of intestinal lymph in the abdominal cavity. Primary chylous ascites is uncommon. We present our experience in the diagnosis and treatment of this condition.

[Prevention of lymphoedema secondary to the treatment of breast cancer: a case report and proposal for a prevention protocol].

Secondary lymphoedema of the upper limbs is a fairly frequent complication of breast cancer treatment. It is related to dissection of the axillary lymph nodes, and manifests itself in the form of clinically important lymphostasis, particularly when the dissection is combined with radiotherapy. Despite the fact that the surgical treatment of mammary cancer has become more conservative and, at the same time, radiotheraphy (when necessary) now proves less aggressive and more efficacious, secondary lymphoedema is still reported with incidence rates ranging from 5 to 25%, with an increase of up to 35% and more, when dissection of the axillary lymph nodes is followed by radiotherapy.