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Surgical Treatment of Postmastectomy Lymphedema – Liposuction

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Lymphedema

Abstract

There are various possible explanations for adipose tissue hypertrophy in lymphedema. There is a physiological imbalance of blood flow and lymphatic drainage, resulting in the impaired clearance of lipids and their uptake by macrophages.1,2 There is increasing support, however, for the view that the fat cell is an endocrine organ and a cytokine-activated cell,3,4 and chronic inflammation plays a role here.5,6

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References

  1. Vague J, Fenasse R. Comparative anatomy of adipose tissue. In: Renold AE, Cahill GF, eds. American Handbook of Physiology, Section 5. Washington DC: American Physiology Society; 1965:25-36.

    Google Scholar 

  2. Ryan TJ. Lymphatics and adipose tissue. Clin Dermatol. 1995;13:493-498.

    Article  PubMed  CAS  Google Scholar 

  3. Mattacks CA, Sadler D, Pond CM. The control of lipolysis in perinodal and other adipocytes by lymph node and adipose tissue derived dendritic cells in rats. Adipocytes. 2005;1:43-56.

    Google Scholar 

  4. Pond CM. Adipose tissue and the immune system. Prostaglandins Leukot Essent Fatty Acids. 2005;73:17-30.

    Article  PubMed  CAS  Google Scholar 

  5. Borley NR, Mortensen NJ, Jewell DP, Warren BF. The relationship between inflammatory and serosal connective tissue changes in ileal Crohn’s disease: evidence for a possible causative link. J Pathol. 2000;190:196-202.

    Article  PubMed  CAS  Google Scholar 

  6. Sadler D, Mattacks CA, Pond CM. Changes in adipocytes and dendritic cells in lymph node containing adipose depots during and after many weeks of mild inflammation. J Anat. 2005;207:769-781.

    Article  PubMed  Google Scholar 

  7. Harvey NL, Srinivasan RS, Dillard ME, et al. Lymphatic vascular defects promoted by Prox1 haploinsufficiency cause adult-onset obesity. Nat Genet. 2005;37:1072-1081.

    Article  PubMed  CAS  Google Scholar 

  8. Schneider M, Conway EM, Carmeliet P. Lymph makes you fat. Nat Genet. 2005;37:1023-1024.

    Article  PubMed  CAS  Google Scholar 

  9. Jones B, Fishman EK, Hamilton SR, et al. Submucosal accumulation of fat in inflammatory bowel disease: CT/pathologic correlation. J Comput Assist Tomogr. 1986;10:759-763.

    Article  PubMed  CAS  Google Scholar 

  10. Sheehan AL, Warren BF, Gear MW, Shepherd NA. Fat-wrapping in Crohn’s disease: pathological basis and relevance to surgical practice. Br J Surg. 1992;79:955-958.

    Article  PubMed  CAS  Google Scholar 

  11. Brorson H, Åberg M, Svensson H. Chronic lymphedema and adipocyte proliferation: clinical therapeutic implications. Lymphology. 2004;37(Suppl):153-155.

    Google Scholar 

  12. Lantz M, Vondrichova T, Parikh H, et al. Overexpression of immediate early genes in active Graves’ ophthalmopathy. J Clin Endocrinol Metab. 2005;90:4784-4791.

    Article  PubMed  CAS  Google Scholar 

  13. Bagheri S, Ohlin K, Olsson G, Brorson H. Tissue tonometry before and after liposuction of arm lymphedema following breast cancer. Lymphat Res Biol. 2005;3:66-80.

    Article  PubMed  Google Scholar 

  14. Brorson H, Ohlin K, Olsson G, Nilsson M. Adipose tissue dominates chronic arm lymphedema following breast cancer: an analysis using volume rendered CT images. Lymphat Res Biol. 2006;4:199-210.

    Article  PubMed  Google Scholar 

  15. Brorson H. Adipose tissue in lymphedema: the ignorance of adipose tissue in lymphedema. Lymphology. 2004;37:135-137.

    Google Scholar 

  16. Brorson H, Ohlin K, Olsson G, Karlsson MK. Breast cancer-related chronic arm lymphedema is associated with excess adipose and muscle tissue. Lymphat Res Biol. 2009;7:3-10.

    Article  PubMed  Google Scholar 

  17. Brorson H, Svensson H. Liposuction combined with controlled compression therapy reduces arm lymphedema more effectively than controlled compression therapy alone. Plast Reconstr Surg. 1998;102:1058-1067. discussion 1068.

    Article  PubMed  CAS  Google Scholar 

  18. Baumeister RG, Siuda S. Treatment of lymphedemas by microsurgical lymphatic grafting: what is proved? Plast Reconstr Surg. 1990;85:64-74. discussion 75-76.

    Article  PubMed  CAS  Google Scholar 

  19. Baumeister RG, Frick A. The microsurgical lymph vessel transplantation. Handchir Mikrochir Plast Chir. 2003;35:202-209.

    Article  PubMed  CAS  Google Scholar 

  20. Campisi C, Davini D, Bellini C, et al. Lymphatic microsurgery for the treatment of lymphedema. Microsurgery. 2006;26:65-69.

    Article  PubMed  CAS  Google Scholar 

  21. Brorson H, Svensson H, Norrgren K, Thorsson O. Liposuction reduces arm lymphedema without significantly altering the already impaired lymph transport. Lymphology. 1998;31:156-172.

    PubMed  CAS  Google Scholar 

  22. Brorson H, Svensson H. Complete reduction of lymphoedema of the arm by liposuction after breast cancer. Scand J Plast Reconstr Surg Hand Surg. 1997;31:137-143.

    Article  PubMed  CAS  Google Scholar 

  23. Brorson H. Liposuction in arm lymphedema treatment. Scand J Surg. 2003;92:287-295.

    PubMed  CAS  Google Scholar 

  24. Brorson H, Ohlin K, Olsson G, Svensson B. Liposuction of postmastectomy arm lymphedema completely removes excess volume: a thirteen year study (Quad erat demonstrandum). Eur J Lymphol. 2007;17:9.

    Google Scholar 

  25. Brorson H, Freccero C, Ohlin K, Svensson B. Liposuction normalizes elephantiasis of the leg. A prospective study with a 6 years follow up. Eur J Lymphol. 2009;20:29.

    Google Scholar 

  26. Brorson H, Ohlin K, Svensson B, Svensson H. Controlled compression therapy and liposuction treatment for lower extremity lymphedema. Lymphology. 2008;41:52-63.

    PubMed  CAS  Google Scholar 

  27. Clayton DN, Clayton JN, Lindley TS, Clayton JL. Large volume lipoplasty. Clin Plast Surg. 1989;16:305-312.

    PubMed  CAS  Google Scholar 

  28. Klein JA. The tumescent technique for liposuction surgery. Am J Cosm Surg. 1987;4:263-267.

    Google Scholar 

  29. Wojnikow S, Malm J, Brorson H. Use of a tourniquet with and without adrenaline reduces blood loss during liposuction for lymphoedema of the arm. Scand J Plast Reconstr Surg Hand Surg. 2007;41:243-249.

    Article  PubMed  Google Scholar 

  30. Brorson H, Ohlin K, Olsson G, Långström G, Wiklund I, Svensson H. Quality of life following liposuction and conservative treatment of arm lymphedema. Lymphology. 2006;39:8-25.

    PubMed  CAS  Google Scholar 

  31. Brorson H, Svensson H. Skin blood flow of the lymphedematous arm before and after liposuction. Lymphology. 1997;30:165-172.

    PubMed  CAS  Google Scholar 

  32. Damstra RJ, Voesten HG, Klinkert P, Brorson H. Circumferential suction-assisted lipectomy for lymphedema after surgery for breast cancer. Br J Surg. 2009;96:859-864.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Håkan Brorson .

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Brorson, H. (2011). Surgical Treatment of Postmastectomy Lymphedema – Liposuction. In: Lee, BB., Bergan, J., Rockson, S. (eds) Lymphedema. Springer, London. https://doi.org/10.1007/978-0-85729-567-5_50

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  • DOI: https://doi.org/10.1007/978-0-85729-567-5_50

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