Matching primary with secondary lymphedemas across lymphatic surgery in genoa (italy) from 1973 until time of covid-19

Corradino CAMPISI, Marlys WITTE, Caterina S. CAMPISI, Lidia MOLINARI, Ezio FULCHERI, Giuseppe VILLA, Samir G. SUKKAR, Giovanni DE CARO, Umberto ROSSI, Francesco PETROCELLI, Mara TACC HELLA, Roberto MARENCO, Roberto RISSO, Arianna DEMORO, Corrado C. CAMPISI

Research output: Contribution to journalReview articlepeer-review

Abstract

Authors report their pluridecennial activity (from 1973 up to today) of research, clinical experience and development of lymphatic surgery in Genoa-Italy, in close collaboration with the worldwide centers of the International Society of Lymphology. Five thousand forty-six cases of patients affected by upper and/or lower limbs, primary and secondary lymphedemas and elephantiasis, between 1973 and 2020 underwent lymphatic microsurgery; and between 2012 and 2020, fibro-lipo-lymph-aspiration, according to lymph vessel sparing procedure (FLLA-LVSP), for latest stages of lymphedema/elephantiasis, previously treated by lymphatic microsurgery with partial improvement of the disease. In addition, also morbid obesity related elephantiasis, lipolymphedema/elephantiasis, chylous-lymphatic dysplastic gravitational reflux with complex related syndromes, were treated by tailored surgical procedures, properly combined with tailored medical and nutritional regimens. All patients were followed-up for a minimum of 5 years to over 20 years. Over 96% of patients with earlier stages of disease (initial lymphedema: Stage IB and increasing lymphedema: Stage IIA) progressively stopped using conservative therapies; and over 80% of patients with later stages (column shaped limb fibrolymphedema: Stage IIB, properly called elephantiasis: Stage IIIA, and extreme elephantiasis: Stage IIIB), significantly decreased the frequency of physical therapies and discontinued compressive garments or stockings. Dermato-lymphangio-adenitis attacks considerably reduced by over 95%. Staging-guided treatment of peripheral lymphedema, according to authors' Genoa protocol, carries out not only the best long-lasting treatment, but also the contextual target of primary (to avoid lymphatic injuries), secondary (early-stage treatment), and tertiary (late-stage treatment) prevention in the potential worsening of the disease.

Original languageEnglish (US)
Pages (from-to)25-41
Number of pages17
JournalItalian Journal of Vascular and Endovascular Surgery
Volume28
Issue number1
DOIs
StatePublished - Mar 2021

Keywords

  • Elephantiasis
  • Lymphedema
  • Lymphoscintigraphy
  • Magnetic resonance imaging
  • Microsurgery
  • Prevention and control

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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