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http://dx.doi.org/10.5999/aps.2020.02215

The relationship between lymphedema severity and awareness of lymphedema surgery  

Lee, Hyun Seung (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine)
Bae, Yong Chan (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine)
Nam, Su Bong (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine)
Yi, Chang Ryul (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine)
Yoon, Jin A (Biomedical Research Institute, Pusan National University Hospital)
Kim, Joo Hyoung (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine)
Publication Information
Archives of Plastic Surgery / v.48, no.5, 2021 , pp. 534-542 More about this Journal
Abstract
Background During the early stages of lymphedema, active physiologic surgical treatment can be applied. However, lymphedema patients often have limited knowledge and misconceptions regarding lymphedema and surgical treatment. We analyzed the correlations between lymphedema severity and surgical technique according to patients' awareness of surgical treatment for secondary upper extremity lymphedema (UEL). Methods Patients with UEL diagnosed between December 2017 and December 2019 were retrospectively evaluated. At the time of their presentation to our hospital for the treatment of lymphedema, they were administered a questionnaire about lymphedema and lymphedema surgery. Based on the results, patients were classified as being aware or unaware of surgical treatment. Lymphedema severity was classified according to the arm dermal backflow (ADB) stage and the MD Anderson Cancer Center (MDACC) stage based on indocyanine green lymphography conducted at presentation. Surgical techniques were compared between the two groups. Results Patients who were aware of surgical treatment had significantly lower initial ADB and MDACC stages (P<0.05) and more frequently underwent physiologic procedures than excisional procedures (P=0.003). Conclusions If patients are actively educated regarding surgical treatment of lymphedema, physiologic procedures may be performed during the early stages of UEL.
Keywords
Breast cancer lymphedema; Upper extremity; Lymphography; Awareness;
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