Peripheral Lymphedema

This book provides extensive knowledge of peripheral lymphedema, including the etiology and pathophysiology of the disease, as well as the anatomy and physiology of the lymphatic system and guide for the treatment of lymphedema to clinicians. The ultimate goal of lymphedema therapy is the targeted and individualized treatment. New technology of multimodality lymphatic imaging emerged in the recent years largely improves the diagnosis of lymphatic circulation disorders. The treatment of peripheral lymphedema is expected to have new achievement. This book illustrates the latest achievements in clinical and basic research of lymphedema to the clinical investigators as well as basic researchers. Pathogenesis of lymphatic system, diagnosis of lymphedema, treatment and further complication management are demonstrated in this book. Some special lymphedema related syndromes, issues on prevention and prognosis are also included.

The partition of fluid between the vascular and interstitial compartments is regulated by forces (hydrostatic and oncotic) operating across the microvascular walls and the surface areas of permeable structures comprising the endothelial barrier to fluid and solute exchange, as well as within the extracellular matrix and lymphatics. In addition to its role in the regulation of vascular volume, transcapillary fluid filtration also allows for continuous turnover of water bathing tissue cells, providing the medium for diffusional flux of oxygen and nutrients required for cellular metabolism and removal of metabolic byproducts. Transendothelial volume flow has also been shown to influence vascular smooth muscle tone in arterioles, hydraulic conductivity in capillaries, and neutrophil transmigration across postcapillary venules, while the flow of this filtrate through the interstitial spaces functions to modify the activities of parenchymal, resident tissue, and metastasizing tumor cells. Likewise, the flow of lymph, which is driven by capillary filtration, is important for the transport of immune and tumor cells, antigen delivery to lymph nodes, and for return of filtered fluid and extravasated proteins to the blood. Given this background, the aims of this treatise are to summarize our current understanding of the factors involved in the regulation of transcapillary fluid movement, how fluid movements across the endothelial barrier and through the interstitium and lymphatic vessels influence cell function and behavior, and the pathophysiology of edema formation. Table of Contents: Fluid Movement Across the Endothelial Barrier / The Interstitium / The Lymphatic Vasculature / Pathophysiology of Edema Formation

An estimated 100 million people around the world suffer from this lifelong condition, a result of damage to the lymphatic system. It causes extreme swelling of a limb or other part of the body along with pain, immobility, disfigurement, an increased susceptibility to infection, and a variety of other symptoms that make many people feel self-conscious and depressed.

In this concise, accessible, and comprehensive reference, world experts in the field of lymphedema detail all of the non-surgical and surgical approaches to the multidisciplinary management of patients with upper and lower extremity lymphedema. There is particular focus on the surgical treatments for lymphedema, where the reader is taken step-by-step through illustrated guides for each procedure by the leading experts in the field of lymphedema microsurgery; from patient selection, preoperative evaluation, surgical technique, and postoperative management. The book is strictly organized so that readers can quickly find content and provides readers with the necessary tools and framework to readily apply these innovative and state-of-the art techniques to their patients to optimize outcomes of surgical and non-surgical treatments for their lymphedema patients. Each chapter features a standardized content layout with full-color illustrations and clinical photographs to visually represent the content and includes key tips from experts in lymphedema, accompanied by key video contributions from the authors to demonstrate the surgical techniques. There is key emphasis on advances in our understand of the etiology of lymphedema, the most important surgical topics in lymphedema microsurgery, the current evidence available for the surgical treatment of lymphedema, and recent advances in lymphedema including new pharmacological treatments that target inflammation and fibrosis Edited by leaders in lymphedema microsurgery and contributed to by a multidisciplinary group of international experts to provide a full and comprehensive guide, Multimodal Management of Upper and Lower Extremity Lymphedema is aimed at a wide target audience that includes surgeons that perform lymphedema surgeries, other medical specialties that treat patients with cancer, lymphedema therapists, physical therapists, and occupational therapists, as well as nursing specialties and trainees.

Thoroughly updated to reflect the latest research, discoveries, and practices in this fast-changing field, Principles and Practice of Lymphedema Surgery, 2nd Edition, provides thorough, step-by-step guidance to incorporate or expand the treatment of lymphedema in your practice. Written and edited by world-renowned experts in the field of lymphedema and microsurgery, this highly visual reference helps deepen your understanding of each procedure and how to perform them. From preoperative assessment to postoperative care, you’ll find authoritative instruction that equips you to implement the most innovative and latest surgical and nonsurgical approaches and achieve optimal outcomes for your patients. Provides an outstanding visual introduction to lymphedema and microsurgery techniques for treatment, as well as newer surgeries and more information on all available treatment options. Offers a step-by-step approach to each procedure, complete with tips and tricks of the trade from leading experts in plastic surgery and lymphedema microsurgery. Features eight all-new chapters covering primary lymphedema treatment, diagnostic tools of lymphoscintigraphy and indocyanine green lymphography, and immediate lymphatic reconstruction. Includes procedural videos of leading international experts performing advanced techniques such as end-end lymphovenous bypass, end-side lymphovenous bypass, submental vascularized lymph node flap, supraclavicular vascularized lymph node flap, and lymphatic vessel mapping with ICG. Enables quick navigation and comprehension with an intuitive, highly templated format and abundant photographs, illustrations, tables, diagrams, and case studies throughout.

This volume is a clinically-oriented book that can be used for patient care, teaching, or research. It covers the entire field of lymphedema, including both primary and secondary disease, as well as all diagnostic and treatment modalities. The text begins with a foundation for the condition, including its pathophysiology, epidemiology, and morbidity. Next, the classification of lymphedema is covered which is the template for accurate diagnosis. Clinical, radiological, and differential diagnosis of lymphedema is also reviewed. Finally, conservative and operative management is presented, including both physiologic and excisional procedures. Lymphedema: Presentation, Diagnosis, and Treatment provides a comprehensive, easy-to-read reference for any health care provider managing a patient with lymphedema. The text is clinically-focused, evidence-based, and practical. The reader, regardless of his/her level of training or specialty, will be able to adequately treat a patient with lymphedema using this resource. To facilitate its use in clinical settings, the book was designed to be portable. In addition, diagnostic and treatment algorithms are included to further simplify the management of these patients. Patient images are presented throughout the text to illustrate the clinical care of lymphedema. All chapters are written by experts in the field, and contain the most current information on the topic.

The second edition of this book serves as a central source of theoretical and practical knowledge to optimize the evaluation and treatment of patients with lymphedema. The book covers all aspects of the disease from anatomical and histological features to diagnosis as well as physical/medical and surgical management of the disease. Updated from the first edition to reflect the substantial progress in diagnostics, medical care and surgical intervention for this patient population, this volume has been reorganized to meet today’s practice requirements. It addresses the challenges faced by clinicians in the management of chronic lymphedema enabling them to meet the medical needs of this large patient community. Edited by world leaders in Vascular Medicine and Surgery, this comprehensive volume provides clear, concise background and recommendations in an easy-to-use format. It is a valuable reference tool for clinical practitioners (physicians/nurse practitioners/technicians) who wish to deliver state-of-the-art health care to their patients with lymphatic and venous disorders.

A comprehensive, evidence-based introduction to the area of lymphology, the book is directed mainly to the US audience and will appeal to an interdisciplinary field of health professionals. It describes the unique anatomy and physiology of the lymphatic system and the intimate relationship it shares with the venous system. It explores the differential diagnosis of the "swollen leg/arm", which is often the presenting problem to the health care professional. The necessity of history taking, physical examination and laboratory studies are noted. Treatment methods are described as an introduction and psychosocial and quality of life issues are explored in depth.