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Non-Melanoma Skin Cancer and Cutaneous Melanoma pp 783–799Cite as

Therapy Principles of Lymphoedema

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Abstract

Lymphoedema is a chronic progressive disease caused by the accumulation of lymph in the interstitial space, which leads to subcutaneous swelling. Since lymph fluid is rich in proteins, it can generate chronic inflammation, proliferation and eventually fibrosclerosis of the affected tissue. The reason for this lymphostatic disease is a mechanical failure due to malfunctioning lymph formation, lymph transport, or both. The cause for this insufficiency can be an organic dysfunction such as alymphoplasia, hyper−/hypoplasia or atresia of the lymphatic vessels, lymphangitis, thrombosis or lymphadenopathy after lymphadenectomy as well as functional problems such as valve insufficiency, vessel wall insufficiency, arrhythmia of vessel pulsation, lymphangiospasm or lymphangioparalysis [1].

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References

  1. Földi E, Földi M. Das Lymphödem. In: Földi E, Földi M, editors. Lehrbuch Lymphologie für Ärzte, Physiotherapeuten und Masseure/med. Bademeister. 7th ed. Auflage, München: Elsevier GmbH, Urban & Fischer; 2011. p. 176–239.

    Google Scholar 

  2. Ferrell RE, Levinson KL, Esman JH, Kimak MA, Lawrence EC, Barmada MM, et al. Hereditary lymphedema: evidence for linkage and genetic heterogeneity. Hum Mol Genet. 1998;7(13):2073–8.

    CAS  PubMed  Google Scholar 

  3. Hach W, Hach-Wunderle V. Primäre und sekundäre Lymphödeme. Gefässchirurgie. 2004;9(1):54–63.

    Google Scholar 

  4. Schuchhardt C, Gültig O, Weissleder H, Pritschow H. Primäres Lymphödem. In: Weissleder H, Schuchhardt C, editors. Erkrankungen des Lymphgefäßsystems. 5th ed. Auflage, Köln: ViaVital; 2011. p. 161–86.

    Google Scholar 

  5. Behrendt P, Strauer BE. Diagnostik und Therapie von Erkrankungen der Lymphgefäße. Internist. 2002;43(1):57–67.

    CAS  Google Scholar 

  6. Lulay GR. Lymphedema. Diagnostics and therapy. Der Chirurg, Zeitschrift für alle Gebiete der operativen Medizin. 2013;84(7):607–16.

    CAS  Google Scholar 

  7. Boris M, Weindorf S, Lasinski BB. The risk of genital edema after external pump compression for lower limb lymphedema. Lymphology. 1998;31(1):15–20.

    CAS  PubMed  Google Scholar 

  8. Schuchhardt C, Vollmer A, Severin N, Gültig O, Schwarz U, Pritschow H, et al. Maßnahmen nach der manuellen Lymphdrainage. In: Pritschow H, Schuchhardt C, editors. Das Lymphödem und die Komplexe Physikalische Entstauungstherapie. 4th ed. Auflage, Köln: Viavital; 2014. p. 172–242.

    Google Scholar 

  9. Rockson SG. Lymphedema. Am J Med. 2001;110(4):288–95.

    CAS  PubMed  Google Scholar 

  10. Sopracordevole F, Mancioli F, Canzonieri V, Buttignol M, Giorda G, Ciavattini A. Laser CO treatment for vulvar lymphedema secondary to gynecological cancer therapy: a report of two cases and review of the literature. Oncol Lett. 2015;9(4):1889–92.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Werner T, Reißhauer A. Behandlung des Lymphödems, Leitlinien der Deutschen Gesellschaft für Physikalische Medizin und Rehabilitation AWMF online–Leitlinie (Internet). 2013. http://www.awmf.org/leitlinien/detail/ll/058-001.html.

  12. Pritschow H, Schuchhardt C. Theoretische Grundlagen der Lymphologie. In: Pritschow H, Schuchhardt C, editors. Das Lymphödem und die komplexe Physikalische Entstauuungstherapie. 4th ed. Auflage, Köln: Viavital; 2014. p. 13–81.

    Google Scholar 

  13. Weissleder H, Brauer WJ. Untersuchungsmethoden. In: Weissleder H, Schuchhardt C, editors. Erkrankungen des Lymphgefäßsystems 2011. 5th ed. Auflage, Köln: Viavital; 2011. p. 74–159.

    Google Scholar 

  14. Narushima M, Yamamoto T, Ogata F, Yoshimatsu H, Mihara M, Koshima I. Indocyanine green lymphography findings in limb lymphedema. J Reconstr Microsurg. 2016;32(1):72–9.

    PubMed  Google Scholar 

  15. Földi E. Therapie des Lymphödems. Hautarzt. 2012;63(8):627–33.

    PubMed  Google Scholar 

  16. Gültig O. Die Erfolgsgeschichte der Lymphologie und der komplexen physikalischen Entstauungstherapie (KPE)–aktuelle Bedeutung. Gefässchirurgie. 2012;17(3):187–93.

    Google Scholar 

  17. Schuchhardt C. Lymphologische Krankheitslehre und therapeutische Ansätze im Verlauf der Jahrhunderte. In: Schuchhardt C, Rabe H, Wittlinger H, editors. Eine kleine Geschichte der Lymphologie. 1st ed. Auflage, Köln: Viavital; 2003. p. 28–32.

    Google Scholar 

  18. Cooper S. Von den Poplitealaneurysmen und ihrer Operation. In: Cooper S, editor. Neuestes Handbuch der Chirurgie in alphabetischer Ordnung. 4th ed. Weimar: Landes-Industrie-Comptoir; 1819. p. 184–94.

    Google Scholar 

  19. Kasseroller RG. The Vodder School: the Vodder method. Cancer. 1998;83(12):2840–2.

    CAS  PubMed  Google Scholar 

  20. Wittlinger H. Entwicklung der konservativem Lymphödemtherapie. In: Schuchhardt C, Wittlinger H, editors. Eine kleine Geschichte der Lymphologie. 1st ed. Auflage, Köln: Viavital; 2003. p. 33–41.

    Google Scholar 

  21. Földi M, Strößenreuther R. Die Grundprinzipien der manuellen Lymphdrainage. In: Grundlagen der manuellen Lymphdrainage. 5th ed. Auflage, München: Urban&Fischer; 2011. p. 37–44.

    Google Scholar 

  22. Ko DS, Lerner R, Klose G, Cosimi AB. Effective treatment of lymphedema of the extremities. Arch Surg. 1998;133(4):452–8.

    CAS  PubMed  Google Scholar 

  23. Schuchhardt C, Gültig O, Weissleder H, Pritschow H. Therapiekonzepte. In: Weissleder H, Schuchhardt C, editors. Erkrankungen des Lymphgefäßsystems 2011. 5th ed. Auflage, Köln: Viavital; 2011. p. 507–616.

    Google Scholar 

  24. Kubik S, Manestar M. Anatomische Grundlagen der Therapie des Lymphödems. Oedem. 1986:19–31.

    Google Scholar 

  25. Hutzschenreuter P, Brümmer H. Die manuelle Lymphdrainage bei der Wundheilung mit Decollement. Eine experimentelle Studie. in: Claudias L, Baumeister RG, Földi E et al. editos. Lymphologica, Zürich: Medikon; 1988:97–100.

    Google Scholar 

  26. Hutzschenreuter P, Einfeldt H, Besser S. In: Hutzschenreuter P, Einfeldt H, Besser S.Lymphologie für die Praxis, Stuttgart: Hippokrates-Verlag; 1991:25–35.

    Google Scholar 

  27. Pritschow H. Die Manuelle Lymphdrainage. In: Pritschow H, Schuchhardt C, editors. Das Lymphödem und die komplexe Physikalische Entstauuungstherapie. 4th ed. Auflage, Köln: Viavital; 2014. p. 78–103.

    Google Scholar 

  28. Fife CE, Davey S, Maus EA, Guilliod R, Mayrovitz HN. A randomized controlled trial comparing two types of pneumatic compression for breast cancer-related lymphedema treatment in the home. Support Care Cancer. 2012;20(12):3279–86.

    PubMed  PubMed Central  Google Scholar 

  29. Sistrunk W. Further experiences with the Kondoleon operation for elephantiasis. JAMA. 1918;71(10):800–6.

    Google Scholar 

  30. Johansson K, Tibe K, Weibull A, Newton RC. Low intensity resistance exercise for breast cancer patients with arm lymphedema with or without compression sleeve. Lymphology. 2005;38(4):167–80.

    CAS  PubMed  Google Scholar 

  31. Thompson N. The surgical treatment of chronic lymphoedema of the extremities. Surg Clin North Am. 1967;47(2):445–503.

    CAS  PubMed  Google Scholar 

  32. Moseley AL, Piller NB, Carati CJ. The effect of gentle arm exercise and deep breathing on secondary arm lymphedema. Lymphology. 2005;38(3):136–45.

    CAS  PubMed  Google Scholar 

  33. Tidhar D, Katz-Leurer M. Aqua lymphatic therapy in women who suffer from breast cancer treatment-related lymphedema: a randomized controlled study. Support Care Cancer. 2010;18(3):383–92.

    PubMed  Google Scholar 

  34. Hutzschenreuter P, Besser S. Praktische Durchführung. In: Hutzschenreuter P, Einfeldt H, Besser S, editors. Lymphologie für die Praxis. Stuttgart: Hippokrates-Verlag; 1991. p. 103–36.

    Google Scholar 

  35. Piller NB. Conservative treatment of acute andchronic lymphoedema with benzo-pyrones. Lymphology. 1976;9(4):132–7.

    CAS  PubMed  Google Scholar 

  36. Piller NB. Lymphoedema, macrophages and benzopyrones. Lymphology. 1980;13(3):109–19.

    CAS  PubMed  Google Scholar 

  37. Piller NB, Clodius L. Benzopyrone (venalot) as a conservative therapy for postmastectomy lymphoedema. In: Weissleder H, Bartos V, Clodius L, et al., editors. Progress in lymphology. Prag: Avicenum Czechoslovak Medical Press; 1979. p. 268–70.

    Google Scholar 

  38. Amann-Vesti BR, Gitzelmann G, Koppensteiner R, Franzeck UK. Isoprostane 8-Epi-Prostaglandin F2α decreases lymph capillary pressure in patients with primary lymphedema. J Vasc Res. 2003;40(1):77–82.

    CAS  PubMed  Google Scholar 

  39. Kasseroller R. Der Einsatz von Selen beim Lymphödem. Med Klin. 1997;92(3):50–1.

    CAS  Google Scholar 

  40. Gothard L, Stanton A, MacLaren J, Lawrence D, Hall E, Mortimer P, et al. Non-randomised phase II trial of hyperbaric oxygen therapy in patients with chronic arm lymphoedema and tissue fibrosis after radiotherapy for early breast cancer. Radiother Oncol. 2004;70(3):217–24.

    CAS  PubMed  Google Scholar 

  41. Pritschow H. Kompression in der KPE und ergänzende Maßnahmen. In: Pritschow H, Schuchhardt C, editors. Das Lymphödem und die komplexe Physikalische Entstauuungstherapie. 4th ed. Auflage, Köln: Viavital; 2014. p. 111–90.

    Google Scholar 

  42. Gothard L, Haviland J, Bryson P, Laden G, Glover M, Harrison S, et al. Randomised phase II trial of hyperbaric oxygen therapy in patients with chronic arm lymphoedema after radiotherapy for cancer. Radiother Oncol. 2010;97(1):101–7.

    CAS  PubMed  Google Scholar 

  43. Tsai HJ, Hung HC, Yang JL, Huang CS, Tsauo JY. Could Kinesio tape replace the bandage in decongestive lymphatic therapy for breast-cancer-related lymphedema? A pilot study. Support Care Cancer. 2009;17(11):1353–60.

    PubMed  Google Scholar 

  44. Lima M, Lima J, de Andrade M, Bergmann A. Low-level laser therapy in secondary lymphedema after breast cancer: systematic review. Lasers Med Sci. 2014;29(3):1289–95.

    Google Scholar 

  45. Weissleder H. Sekundäres Lymphödem in der Tumornachsorge. In: Weissleder H, Schuchhardt C, editors. Erkrankungen des Lymphgefäßsystems. 5th ed. Auflage, Köln: Viavital; 2011. p. 284–91.

    Google Scholar 

  46. Kim DI, Huh SH, Hwang JH, Joh JH. Excisional surgery for chronic advanced lymphedema. Surg Today. 2004;34(2):134–7.

    PubMed  Google Scholar 

  47. Sapountzis S, Ciudad P, Lim SY, Chilgar RM, Kiranantawat K, Nicoli F, et al. Modified Charles procedure and lymph node flap transfer for advanced lower extremity lymphedema. Microsurgery. 2014;34(6):439–47.

    PubMed  Google Scholar 

  48. Boyages J, Kastanias K, Koelmeyer LA, Winch CJ, Lam TC, Sherman KA, Munnoch DA, Brorson H. Liposuction for advanced lymphedema: a multidisciplinary approach for complete reduction of arm and leg swelling. Ann Surg Oncol. 2015;22(Suppl 3):1263–70.

    PubMed Central  Google Scholar 

  49. Nguyen AT, Chang EI, Suami H, Chang DW. An algorithmic approach to simultaneous vascularized lymph node transfer with microvascular breast reconstruction. Ann Surg Oncol. 2015;22(9):2919–24.

    PubMed  Google Scholar 

  50. Koshima I, Narushima M, Yamamoto Y, Mihara M, Iida T. Recent advancement on surgical treatments for lymphedema. Ann Vasc Dis. 2012;5(4):409–15.

    PubMed  PubMed Central  Google Scholar 

  51. Tretbar LL, Morgan CL, Lee BB, Simonian SJ, Blondeau B. Surgical management. In: Lymphedema: diagnosis and treatment. London: Springer; 2008. p. 55–63.

    Google Scholar 

  52. Dellon AL, Hoops JE. The Charles procedure for primary lymphedema: long-term clinical results. Plast Reconstr Surg. 1977;60(4):589–95.

    CAS  PubMed  Google Scholar 

  53. Homans J. The treatment of elephantiasis of the legs: a preliminary report. N Engl J Med. 1936;215(24):1099–104.

    Google Scholar 

  54. Kinmonth JB, Patrick JH, Chilvers AS. Comments on operations for lower limb lymphoedema. Lymphology. 1975;8(2):56–61.

    CAS  PubMed  Google Scholar 

  55. Granzow JW, Soderberg JM, Kaji AH, Dauphine C. Review of current surgical treatments for lymphedema. Ann Surg Oncol. 2014;21(4):1195–201.

    PubMed  Google Scholar 

  56. Yamamoto Y, Horiuchi K, Sasaki S, Sekido M, Furukawa H, Oyama A, et al. Follow-up study of upper limb lymphedema patients treated by microsurgical lymphaticovenous implantation (MLVI) combined with compression therapy. Microsurgery. 2003;23(1):21–6.

    PubMed  Google Scholar 

  57. Chang DW. Lymphaticovenular bypass for lymphedema management in breast cancer patients: a prospective study. Plast Reconstr Surg. 2010;126(3):752–8.

    CAS  PubMed  Google Scholar 

  58. Huang GK. Ergebnisse mikrochirurgischer lymphovenöser Anastomosen bei Lymphödemen—Bericht über 110 Fälle. Langenbecks Arch Chiv. 1989;374(4):194–9.

    CAS  Google Scholar 

  59. Damstra RJ, Voesten HG, van Schelven WD, van der Lei B. Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature. Breast Cancer Res Treat. 2009;113(2):199–206.

    CAS  PubMed  Google Scholar 

  60. Campisi C, Davini D, Bellini C, Taddei G, Villa G, Fulcheri E, et al. Lymphatic microsurgery for the treatment of lymphedema. Microsurgery. 2006;26(1):65–9.

    CAS  PubMed  Google Scholar 

  61. Campisi C, Eretta C, Pertile D, Da Rin E, Campisi C, Maccio A, et al. Microsurgery for treatment of peripheral lymphedema: long-term outcome and future perspectives. Microsurgery. 2007;27(4):333–8.

    PubMed  Google Scholar 

  62. Baumeister RH, Scifert J, Wiebecke B, Hahn D. Experimental basis and first application of clinical lymph vessel transplantation of secondary lymphedema. World J Surg. 1981;5(3):401–7.

    CAS  PubMed  Google Scholar 

  63. Baumeister RH. Lymphatic vessel transplantation. In: Greene AK, Slavin SA, Brorson H, editors. Lymphedema—presentation, diagnosis, treatment. 1st ed. Berlin-Heidelberg-Zurich: Springer-Verlag; 2015. p. 247–54.

    Google Scholar 

  64. Baumeister RH. Lymphgefäße. In: Luther B, editor. Techniken der offenen Gefäßchirurgie: standards, taktiken, tricks. Berlin-Heidelberg-Zurich: Springer-Verlag; 2014. p. 471–9.

    Google Scholar 

  65. Baumeister R, Frick A. The microsurgical lymph vessel transplantation. Handchir Mikrochir Plast Chir. 2003;35(4):202–9.

    CAS  PubMed  Google Scholar 

  66. Gharb BB, Rampazzo A, Spanio di Spilimbergo S, Xu ES, Chung KP, Chen HC. Vascularized lymph node transfer based on the hilar perforators improves the outcome in upper limb lymphedema. Ann Plast Surg. 2011;67(6):589–93.

    CAS  PubMed  Google Scholar 

  67. Sapountzis S, Singhal D, Rashid A, Ciudad P, Meo D, Chen HC. Lymph node flap based on the right transverse cervical artery as a donor site for lymph node transfer. Ann Plast Surg. 2014;73(4):398–401.

    CAS  PubMed  Google Scholar 

  68. Flynn TC. The history of Liposuction. In: Shiffman MA, Di Giuseppe A, editors. Liposuction: principles and practice. 2nd ed. Berlin-Heidelberg-Zurich: Springer-Verlag; 2016. p. 3–6.

    Google Scholar 

  69. Frick A, Hoffmann JN, Baumeister RG, Putz R. Liposuction technique and lymphatic lesions in lower legs: anatomic study to reduce risks. Plast Reconstr Surg. 1999;103(7):1868–73.

    CAS  PubMed  Google Scholar 

  70. Granzow JW, Soderberg JM, Kaji AH, Dauphine C. An effective system of surgical treatment of lymphedema. Ann Surg Oncol. 2014;21(4):1189–94.

    PubMed  Google Scholar 

  71. Cornely ME. Lipedema and lymphatic edema. In: Shiffman MA, Di Giuseppe A, editors. Liposuction: principles and practice. Berlin-Heidelberg-Zurich: Springer-Verlag; 2006. p. 547–55.

    Google Scholar 

  72. Todokoro T, Furniss D, Oda K, Kawana K, Narushima M, Mihara M, Kikuchi K, Hara H, Yano T, Koshima I. Effective treatment of pelvic lymphocele by lymphaticovenular anastomosis. Gynecol Oncol. 2013;128(2):209–14.

    PubMed  Google Scholar 

  73. Yamamoto T, Yamamoto N, Furuya M, Hayashi A, Koshima I. Genital lymphedema score: genital lymphedema severity scoring system based on subjective symptoms. Ann Plast Surg. 2016;77(1):119–21.

    CAS  PubMed  Google Scholar 

  74. Lang E, Munder B, Andree C, Foeldi E, Felmerer G, Stark G. A modified therapeutic option for a long lasting success in the treatment of genital lymphedema. Eur J Plast Surg. 2006;29(1):13–8.

    Google Scholar 

  75. Bruns F, Buentzel J, Mücke R, Schönekaes K, Kisters K, Micke O. Selenium in the treatment of head and neck lymphedema. Med Princ Pract. 2004;13(4):185–90.

    CAS  PubMed  Google Scholar 

  76. Zimmermann T, Leonhardt H, Kersting S, Albrecht S, Range U, Eckelt U. Reduction of postoperative lymphedema after oral tumor surgery with sodium selenite. Biol Trace Elem Res. 2005;106(3):193–203.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, Alexandroupoli, Greece

    Nikolaos A. Papadopulos

  2. Research Group for Studies on Quality of Life after Plastic, Reconstructive, Aesthetic & Hand Surgery, Department of Plastic Surgery and Hand Surgery, University Hospital rechts der Isar, Munich Technical University, Munich, Germany

    Nikolaos A. Papadopulos

  3. Visiting Professor, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

    Nikolaos A. Papadopulos

  4. Department of Plastic Surgery and Hand Surgery, University Hospital rechts der Isar, Munich Technical University, Munich, Germany

    Antonia Stührenberg & Min-Seok Kwak

  5. Queen Mary University of London, London, UK

    Dimitrios Karypidis

  6. Private Practice, Metropolitan General Hospital, Athens, Greece

    Fotios-Filippos Karantonis

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Correspondence to Nikolaos A. Papadopulos .

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Editors and Affiliations

  1. Emeritus Professor, Plastic, Reconstructive and Aesthetic Surgery, National and Kapodistrian University of Athens Medical School, Athens, Greece

    Othon Papadopoulos

  2. Professor and Chairman, Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, Alexandroupoli, Greece

    Nikolaos A. Papadopulos

  3. Academic Fellow, National and Kapodistrian, University of Athens, Medical School, Athens, Greece

    Grigorios Champsas

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Papadopulos, N.A., Stührenberg, A., Karypidis, D., Karantonis, FF., Kwak, MS. (2020). Therapy Principles of Lymphoedema. In: Papadopoulos, O., Papadopulos, N.A., Champsas, G. (eds) Non-Melanoma Skin Cancer and Cutaneous Melanoma. Springer, Cham. https://doi.org/10.1007/978-3-030-18797-2_29

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