title: A Detailed Examination of the Characteristics and Treatment in a Series of 33 Idiopathic Lymphedema Patients.
abstract: BackgroundTo date, only a few reports have been published on idiopathic lymphedema, and most of these are case reports. In this time, we performed a retrospective review of idiopathic lymphedema patients.MethodsForty patients presented with idiopathic lymphedema that was unrelated to surgery, injury, and medical conditions such as circulatory disease, kidney disease, and thrombotic venous disease. For these patients, we performed a retrospective review for edema-onset age, sex, location and stage of the edema, presence of cellulitis, episode related to edema onset, therapeutic intervention, and follow-up duration in the 33 patients whom we followed up.ResultsAmong the 33 patients with idiopathic lymphedema, there were 11 patients with either congenital or childhood-onset lymphedema, 14 with adult-onset lymphedema, and the remaining 8 patients had an onset age of >60 years. Twenty of the 33 patients had undergone surgical treatment. Of the 19 patients who underwent lymphaticovenular anastomosis (LVA), 2 had good, 4 had fair, and 13 had poor treatment outcomes. Twelve patients successfully received only conservative treatment and follow-up for more than 3 months, without operation. The treatment outcome in these 12 patients was as follows: excellent in 4 patients, good in 6, and fair in 2 patients.ConclusionIn this study, the usefulness of LVA for most patients with idiopathic lymphedema was not confirmed. Although this review did not include a conducted case, the indication for new surgical treatments such as vascularized lymph node transfer should be considered in the future.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Okayama University, Okayama, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Onoda
authors.affiliation: Department of Plastic and Reconstructive Surgery, Okayama University, Okayama, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Department of Plastic and Reconstructive Surgery, Okayama University, Okayama, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: Department of Plastic and Reconstructive Surgery, Okayama University, Okayama, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kimata
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods*; D002481:Cellulitis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008197:Lymph Node Excision / Q000379:methods*; D008209:Lymphedema / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult