A Systematic Review of Outcomes After Genital Lymphedema Surgery: Microsurgical Reconstruction Versus Excisional Procedures.

Details

Serval ID
serval:BIB_2A22D215C783
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A Systematic Review of Outcomes After Genital Lymphedema Surgery: Microsurgical Reconstruction Versus Excisional Procedures.
Journal
Annals of plastic surgery
Author(s)
Guiotto M., Bramhall R.J., Campisi C., Raffoul W., di Summa P.G.
ISSN
1536-3708 (Electronic)
ISSN-L
0148-7043
Publication state
Published
Issued date
12/2019
Peer-reviewed
Oui
Volume
83
Number
6
Pages
e85-e91
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Genital lymphedema (GL) surgery can be either palliative or functional. Palliative procedures involve excision of the affected tissue and reconstruction by either local flaps or skin grafts. Reconstructive procedures aim to restore lymphatic flow through microsurgical lymphaticovenous anastomoses (LVAs). This systematic analysis of outcomes and complication rates aims to compare outcomes between these surgical treatment options for GL.
A systematic review of the PubMed database was performed with the following search algorithm: (lymphorrhea or lymphedema) and (genital or scrotal or vulvar) and (microsurgery or "surgical treatment"), evaluating outcomes, and complications after surgical treatment of GL.
Twenty studies published between 1980 and 2016 met the inclusion criteria (total, 151 patients). Three main surgical treatments for GL were identified. Surgical resection and primary closure or skin graft was the most common procedure (46.4%) with a total complication rate of 10%. Surgical resection and flap reconstruction accounted for 39.1% of the procedures with an overall complication rate of 54.2%. Lympho venous shunt (LVA) procedures (14.5%) had a total complication rate of 9%.
This review demonstrates a lack of consensus in both the preoperative assessment and surgical management of GL. Patients receiving excisional procedures tended to be later stage lymphedema. Patients in the excision and flap reconstruction group seemed to have the highest complication rates. Microsurgical LVAs may represent an alternative approach to GL, either alone or in combination with traditional procedures.
Pubmed
Web of science
Create date
07/01/2020 11:56
Last modification date
02/06/2020 5:26
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