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Genital Lymphedema and How to Deal with It: Pearls and Pitfalls from over 38 Years of Experience with Unusual Lymphatic System Impairment

Background and Objectives: Conservative treatment represents an essential pillar of lymphedema management, along with debulking and physiologic surgeries. Despite the consistent number of treatment options, there is currently no agreement on their indications and possible combinations. When dealing...

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Autores principales: Kaciulyte, Juste, Garutti, Leonardo, Spadoni, Davide, Velazquez-Mujica, Jonathan, Losco, Luigi, Ciudad, Pedro, Marcasciano, Marco, Lo Torto, Federico, Casella, Donato, Ribuffo, Diego, Chen, Hung-Chi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8618468/
https://www.ncbi.nlm.nih.gov/pubmed/34833393
http://dx.doi.org/10.3390/medicina57111175
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author Kaciulyte, Juste
Garutti, Leonardo
Spadoni, Davide
Velazquez-Mujica, Jonathan
Losco, Luigi
Ciudad, Pedro
Marcasciano, Marco
Lo Torto, Federico
Casella, Donato
Ribuffo, Diego
Chen, Hung-Chi
author_facet Kaciulyte, Juste
Garutti, Leonardo
Spadoni, Davide
Velazquez-Mujica, Jonathan
Losco, Luigi
Ciudad, Pedro
Marcasciano, Marco
Lo Torto, Federico
Casella, Donato
Ribuffo, Diego
Chen, Hung-Chi
author_sort Kaciulyte, Juste
collection PubMed
description Background and Objectives: Conservative treatment represents an essential pillar of lymphedema management, along with debulking and physiologic surgeries. Despite the consistent number of treatment options, there is currently no agreement on their indications and possible combinations. When dealing with unusual lymphedema presentation as in the genitalia (Genital Lymphedema—GL), treatment choice becomes even more difficult. The authors aimed to present their targeted algorithm of single and combined treatment modalities for rare GL in order to face this paucity of information. Materials and Methods: Data were collected from a prospectively maintained database since January 1983, and cases of GL that were managed in the authors’ department were selected. Only patients that were treated in the authors’ institution and presented a minimum follow-up of 3 months were admitted to the current study. Results: From January 1983 to July 2021, 19 patients with GL were recruited. All the patients were male, and their ages ranged from 21 to 73 years old (average: 52). Ten cases (52.6%) presented with ISL (International Society of Lymphology) stage I, five (26.3%) were stage II and four (21.1%) were stage III. GL was managed with conservative treatment (12 cases), LVA (LymphaticoVenous Anastomosis) (3) or surgical excision (4). In a mean follow-up of 7.5 years (range: 3 months—11 years), no major complications occurred, and all cases reached improvements in functional and quality of life terms. Conclusions: Contrary to the predominant thought of the necessity to avoid surgery in unusual lymphedema presentations such as GL, they can be managed using targeted multimodal approaches or by adapting well-known procedures in unusual ways to achieve control of disease progression and improve patients’ quality of life.
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spelling pubmed-86184682021-11-27 Genital Lymphedema and How to Deal with It: Pearls and Pitfalls from over 38 Years of Experience with Unusual Lymphatic System Impairment Kaciulyte, Juste Garutti, Leonardo Spadoni, Davide Velazquez-Mujica, Jonathan Losco, Luigi Ciudad, Pedro Marcasciano, Marco Lo Torto, Federico Casella, Donato Ribuffo, Diego Chen, Hung-Chi Medicina (Kaunas) Article Background and Objectives: Conservative treatment represents an essential pillar of lymphedema management, along with debulking and physiologic surgeries. Despite the consistent number of treatment options, there is currently no agreement on their indications and possible combinations. When dealing with unusual lymphedema presentation as in the genitalia (Genital Lymphedema—GL), treatment choice becomes even more difficult. The authors aimed to present their targeted algorithm of single and combined treatment modalities for rare GL in order to face this paucity of information. Materials and Methods: Data were collected from a prospectively maintained database since January 1983, and cases of GL that were managed in the authors’ department were selected. Only patients that were treated in the authors’ institution and presented a minimum follow-up of 3 months were admitted to the current study. Results: From January 1983 to July 2021, 19 patients with GL were recruited. All the patients were male, and their ages ranged from 21 to 73 years old (average: 52). Ten cases (52.6%) presented with ISL (International Society of Lymphology) stage I, five (26.3%) were stage II and four (21.1%) were stage III. GL was managed with conservative treatment (12 cases), LVA (LymphaticoVenous Anastomosis) (3) or surgical excision (4). In a mean follow-up of 7.5 years (range: 3 months—11 years), no major complications occurred, and all cases reached improvements in functional and quality of life terms. Conclusions: Contrary to the predominant thought of the necessity to avoid surgery in unusual lymphedema presentations such as GL, they can be managed using targeted multimodal approaches or by adapting well-known procedures in unusual ways to achieve control of disease progression and improve patients’ quality of life. MDPI 2021-10-28 /pmc/articles/PMC8618468/ /pubmed/34833393 http://dx.doi.org/10.3390/medicina57111175 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kaciulyte, Juste
Garutti, Leonardo
Spadoni, Davide
Velazquez-Mujica, Jonathan
Losco, Luigi
Ciudad, Pedro
Marcasciano, Marco
Lo Torto, Federico
Casella, Donato
Ribuffo, Diego
Chen, Hung-Chi
Genital Lymphedema and How to Deal with It: Pearls and Pitfalls from over 38 Years of Experience with Unusual Lymphatic System Impairment
title Genital Lymphedema and How to Deal with It: Pearls and Pitfalls from over 38 Years of Experience with Unusual Lymphatic System Impairment
title_full Genital Lymphedema and How to Deal with It: Pearls and Pitfalls from over 38 Years of Experience with Unusual Lymphatic System Impairment
title_fullStr Genital Lymphedema and How to Deal with It: Pearls and Pitfalls from over 38 Years of Experience with Unusual Lymphatic System Impairment
title_full_unstemmed Genital Lymphedema and How to Deal with It: Pearls and Pitfalls from over 38 Years of Experience with Unusual Lymphatic System Impairment
title_short Genital Lymphedema and How to Deal with It: Pearls and Pitfalls from over 38 Years of Experience with Unusual Lymphatic System Impairment
title_sort genital lymphedema and how to deal with it: pearls and pitfalls from over 38 years of experience with unusual lymphatic system impairment
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8618468/
https://www.ncbi.nlm.nih.gov/pubmed/34833393
http://dx.doi.org/10.3390/medicina57111175
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