Background And Purpose: Lymphedema is an incurable complication of breast cancer treatment that affects roughly 20 percent of women. It is often managed via complete decongestive therapy, which includes manual lymph drainage, therapeutic compression, skin care, and exercise. Lymph node transfer is a new and expensive surgical intervention that uses one's own lymph nodes and implants them in the affected upper extremity. Previous research has investigated augmenting lymph node transfer surgery with complete decongestive therapy, but there is a lack of evidence regarding the success of focusing lymph drainage against the normal pressure gradient toward a surgical flap located on the wrist. The patient's main motivation for the surgical intervention was to alleviate her daily burden of complete decongestive therapy. The purpose of this case report was to compare the methods and results of pre-surgical complete decongestive physical therapy to a post-operation modified approach that directed lymph fluid away from the major lymphatic ducts and instead toward a surgical flap on the wrist of a patient with lymphedema.
Case Description: A 65-year-old female presented with secondary upper extremity lymphedema following breast cancer treatment. Her circumferential measurements and L-Dex score corroborated this diagnosis, and she had functional deficits in upper extremity range of motion. She was seen for 10 visits of traditional complete decongestive therapy prior to her lymph node transfer surgery and 24 treatments of modified complete decongestive therapy over the course of six months following surgery.
Outcomes: At six months, the patient had minor improvements in the Functional Assessment of Chronic Illness Therapy-Fatigue, Disabilities of the Arm, Shoulder and Hand questionnaire, range of motion, and upper extremity strength. However, her circumferential measurements and L-Dex scores showed a meaningful increase in limb girth.
Discussion: The patient's smallest upper extremity volumes were documented before the operation after two weeks of complete decongestive therapy. The surgical intervention supplemented by modified complete decongestive therapy resulted in increased limb girth after six months. Although the patient was able to stop wearing her compression garment while continuing independent manual lymph drainage and upper extremity wrapping, the post-surgical intervention was not a success because the patient's circumferential measurements remained meaningfully higher than at her initial examination. Further research is needed to determine the long-term effects of this surgery when coupled with physical therapy intervention, and whether it has better outcomes than the standard conservative treatment of complete decongestive therapy alone.
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Eur J Orthop Surg Traumatol
December 2024
Istanbul Physical Medicine and Rehabilitation Training Research Hospital, Istanbul, Turkey.
Objective: The aim of the current study is to demonstrate the treatment results of patients with lymphedema that developed after total knee arthroplasty (TKA) and to compare these results with those of patients with secondary lymphedema non-TKA.
Methods: A total of 63 patients diagnosed with secondary lymphedema and who received complete decongestive treatment (MLD + bandaging + exercise) at the lymphedema treatment unit of Istanbul Physical Medicine and Rehabilitation Training Research Hospital between June 1, 2023, and February 1, 2024, were included in our retrospective study. The circumference of both metatarsophalangeal joints was measured, and leg diameter measurements were made from the lateral malleolus to the proximal 10th, 20th, and 30th centimeters.
J Tehran Heart Cent
January 2024
Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Background: Acute heart failure is a common clinical syndrome leading to hospital admission, with few evidence-based therapies for managing congestion. This trial aims to assess the efficacy of acetazolamide combined with loop diuretics in achieving decongestion among patients who fail to respond to oral diuretics and progress to acute decompensated heart failure in the absence of injectable furosemide.
Methods: This single-center, double-blind randomized controlled trial with a 1:1 allocation ratio aims to evaluate 130 patients admitted to the infusion ward.
Phlebology
December 2024
Physical Medicine and Rehabilitation, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye.
Introduction: The increasing reliance on Internet search engines for health-related queries requires a thorough evaluation of the public's engagement with medical information. This study aims to analyze global trends in interest in lymphedema over the past decade using Google Trends (GT).
Methods: A physiatrist with expertise in lymphedema management identified and analyzed 12 key search terms according to the International Society of Lymphology (ISL) guidelines.
J Clin Med
November 2024
Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
: Breast cancer-related lymphedema (BCRL) reduces the quality of life of patients and limits their activities of daily living. Even though resistance exercises seemed to be safe in BCRL patients, it was still controversial that resistance exercises improve lymphedema. Therefore, we sought to evaluate the effects of forearm-targeted resistance exercises on BCRL using segmental bioelectrical impedance analysis (BIA).
View Article and Find Full Text PDFLymphat Res Biol
December 2024
Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA.
Lymphedema is a chronic condition characterized by dysfunction of the lymphatic system. There is currently no available cure. The standard of care is complete decongestive physiotherapy performed by a lymphedema therapist.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!