Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Primary LYmphedema Multidisciplinary Approach (P-LYMA) in Patients Affected by Primary Lower Extremity Lymphedema

Version 1 : Received: 30 June 2023 / Approved: 30 June 2023 / Online: 3 July 2023 (03:08:07 CEST)

How to cite: Ciudad, P.; Bolletta, A.; Kaciulyte, J.; Manrique, O.J.; Escandón, J.M. Primary LYmphedema Multidisciplinary Approach (P-LYMA) in Patients Affected by Primary Lower Extremity Lymphedema. Preprints 2023, 2023062230. https://doi.org/10.20944/preprints202306.2230.v1 Ciudad, P.; Bolletta, A.; Kaciulyte, J.; Manrique, O.J.; Escandón, J.M. Primary LYmphedema Multidisciplinary Approach (P-LYMA) in Patients Affected by Primary Lower Extremity Lymphedema. Preprints 2023, 2023062230. https://doi.org/10.20944/preprints202306.2230.v1

Abstract

Background: Primary lymphedema is a chronic condition caused by a developmental abnormality of the lymphatic system and its malfunction. Different surgical options such as physiologic and excisional procedures have been proposed. The aim of this study was to present a complete algorithm for the treatment of primary lower extremity lymphedema: Primary LYmphedema Multidisciplinary Approach (P-LYMA). Methods: Nineteen patients were treated according to the P-LYMA. Patients underwent pre- and post-operative complex decongestive therapy (CDT). Different physiologic and excisional procedures were performed independently or in combination. The primary outcome was the circumferential reduction rate (CRR). The Lymphedema Quality of Life Score (LeQOLiS), reduction in the number of episodes of cellulitis, length of stay, and complications were recorded. Results: The mean CRR calculated was 72.8±19.6% after twelve months. The episodes of cellulitis per year decreased from a mean of 1.9±0.8 preoperative to 0.4± 0.6 throughtout follow-up. Two patients experienced minor complications. Mean hospitalization time was 5 days. Patients’ quality of life (LeQOLi score) drastically improved from 70.4±11.6 to 24.2 ±13.9 at twelve months post-op. Conclusion: The P-LYMA algorithm allows to maximize surgical results and improve the quality-of life in patients who suffer from primary lymphedema. CDT is mandatory to optimize results.

Keywords

Lymphedema; supermicrosurgery; suction-assisted lipectomy (SAL); lymphatico-venous anastomoses (LVA); vascularized lymph node transfer.

Subject

Medicine and Pharmacology, Surgery

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