Fisiopatologia, diagnóstico e tratamento do linfedema: revisão narrativa / Pathophysiology, diagnosis and treatment of lymphedema: narrative review
DOI:
https://doi.org/10.34119/bjhrv5n4-042Keywords:
linfedema, microcirurgia, anastomose linfovenosa.Abstract
Linfedema é uma condição clínica debilitante, incurável e progressiva, sendo resultado do acúmulo do fluido extracelular rico em proteína no espaço intersticial. A longo prazo, o acúmulo de linfa desencadeia um processo inflamatório crônico no membro acometido. Com a progressão da doença, os vasos linfáticos tornam-se sobrecarregados, gerando fibrose tecidual e diminuindo consideravelmente a funcionalidade do sistema. Considerando isto, a realização de tratamentos cirúrgicos que visam restabelecer a fisiologia linfática podem não provocar resultados satisfatórios. A implementação de técnicas de supermicro cirurgia amplia as possibilidades terapêuticas e permite a melhora da qualidade de vida de muitas pessoas. No entanto, faz-se necessário estudos longitudinais para melhor compreender a resposta terapêutica a longo prazo.
References
Borman P. Lymphedema diagnosis, treatment, and follow-up from the view point of physical medicine and rehabilitation specialists. Turk J Phys Med Rehabil. 2018;64(3):179-197.
Gallagher K, Marulanda K, Gray S. Surgical Intervention for Lymphedema. Surg Oncol Clin N Am. 2018;27(1):195-215.
Michelini S. Lymphedema etiology, epidemiology and clinical staging. In: Michelini S, Failla A, Moneta G, Cardone M, editors. Compression therapy in lymphatic Insufficiency. Milano: Cizeta-Medicali; 2010. p. 14-8.
Garza R 3rd, Skoracki R, Hock K, Povoski SP. A comprehensive overview on the surgical management of secondary lymphedema of the upper and lower extremities related to prior oncologic therapies. BMC Cancer. 2017;17(1):468.
Mortimer PS, Rockson SG. New developments in clinical aspects of lymphatic disease. J Clin Invest. 2014;124(3):915–21.
Cheng MH, Huang JJ, Wu CW, Yang CY, Lin CY, Henry SL, Kolios L. The mechanism of vascularized lymph node transfer for lymphedema: natural lymphaticovenous drainage. Plast Reconstr Surg. 2014;133(2):192e–8e.
Greene AK Epidemiology and morbidity of lymphedema. In: Greene AK, Slavin SA, Brorson H, editors. Lymphedema Presentation, Diagnosis and Treatment. Switzerland: Springer; 2015. p. 33-50.
Allen RJ Jr, Cheng MH. Lymphedema surgery: Patient selection and an overview of surgical techniques. J Surg Oncol. 2016;113(8):923-931.
Evans AL, Brice G, Sotirova V, Mortimer P, Beninson J, Burnand K, et al. Mapping of primary congenital lymphedema to the 5q35.3 region. Am J Hum Genet. 1999;64(2):547-55.
Murdaca G, Cagnati P, Gulli R, Spanò F, Puppo F, Campisi C, et al. Current views on diagnostic approach and treatment of lymphedema. Am J Med. 2012;125(2):134-40.
Pérez-Pereira A, González-Movilla C. Primer Curso Intensivo de Revisión em Medicina Física Rehabilitación. Vigo: Complexo Hospitalario Universitário de Vigo; 2008;56:671-83.
Witte MH, Erickson R, Bernas M, Andrade M, Reiser F, Conlon W, et al. Phenotypic and genotypic heterogeneity in familial Milroy lymphedema. Lymphology. 1998;31(4):145-55.
Táboas Maria Inês, Torres Ana, Popik Igor, Casalta Paulo, Lima Luís, Linfedema: revisão e integração de um caso clínico. Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação. V.n.23 p70-78 2013
Connel F, Brice G, Mortimer P. Phenotypic characterization of primary lymphedema. Ann N Y Acad Sci. 2008;1131:140-6.
Erickson RP. Lymphedema-distichiasis and FOXC2 gene mutations. Lymphology 2001;34(1):1.
Rezaie T, Ghoroghchian R, Bell R, Brice G, Hasan A, Burnand K, et al. Primary non-syndromic lymphoedema (Meige disease) is not caused by mutations in FOXC2. Eur J Hum Genet. 2008;16(3):300-4
Kerchner K, Fleischer A, Yosipovitch G. Lower extremity lymphedema. Update: pathophysiology, diagnosis, and treatment guidelines. J Am Acad Dermatol. 2008;59:324-31.
International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2003 Consensus of the International Society of Lymphology Executive. Lymphology. 2003;36(2):84-91.
Cormier JN, Askew RL, Mungovan KS, Xing Y, Ross MI, Armer JM, et al. Lymphedema beyond breast cancer: a systematic review and meta-analysis of cancer related secondary lymphedema. Cancer .2010;116(22):5138-49.
Petrek JA, Senie RT, Peters M, et al. Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Cancer 2001;92(6):1368–77.
Armer JM, Stewart BR. Post-breast cancer lymphedema: incidence increases from 12 to 30 to 60 months. Lymphology 2010;43(3):118–27.
Maclellan RA, Couto RA, Sullivan JE, Grant FD, Slavin SA, Greene AK. Management of primary and secondary lymphedema: analysis of 225 referrals to a center. Ann Plast Surg. 2015;75(2):197–200.
Schimitz KH, Troxel AB, Cheville, et al. Physical Activity abd Lymphedema (the PAL trial): assessing the safety of progressive strength training in breast cancer survivors. Contemp Clin Trials 2009;30(3):233-45
Radina E. Armer J, Daunt D, et al. self-reported information management of breast cancer-related lymphedema. J Lymphoedema 2007;2(2):12-21
Armer JM, Hulett JM, Bernas M, et al.: Best practice guidelines in assessment, risk reduction, management, and surveillance for post-breast cancer lymphedema. Curr Breast Cancer Rep 2013;5:134–144.
Moffatt C, Franks P, Doherty D, et al. Lymphoedema: an underestimated health problem. QJM 2003;96(10):731-8
Ohberg F, Zachrisson A, Holmner-Rocklöv A. Three-dimensional camera system for measuring arm volume in women with lymphedema following breast cancer treatment. Lymphat Res Biol. 2014;12(4):267–74.
Cheng, Ming-Huei et Al. Lymphedema Surgery. 1 ed. Elsevier. 2016
Stout NL, Binkley JM, Schimitz KH, et al. A prospective surveillance model for rehabilitation for women with breast cancer. Cancer 2012;118:2191-200
McLaughlin SA, Bagaria S, Gibson T, et al. Trends in risk reduction practices for the prevention of lymphedema in the first 12 months after breast cancer surgery. J Am Coll Surg 2013;206(3):380-9
Granzow JW, Soderberg JM, Kaji AH, Dauphine C. An effective system of surgical treatment of lymphedema. Ann Surg Oncol. 2014;21(4):1189-1194.
Yamada Y: The studies on lymphatic venous anastomosis in lymphedema. Nagoya J Med Sci 1969;32:1–21.
Koshima I, Narushima M, Yamamoto Y, et al.: Recent advancement on surgical treatments for lymphedema. Ann Vasc Dis 2012;5:409–415.
Chang DW, Suami H, Skoracki R: A prospective analysis of 100 consecutive lymphovenous bypass cases for treatment of extremity lymphedema. Plast Reconstr Surg 2013;132:1305–1314.
O'Brien BM, Sykes P, Threlfall GN, Browning FS. Microlymphaticovenous anastomoses for obstructive lymphedema. Plast Reconstr Surg. 1977;60(2):197–211.
Cormier JN, Rourke L, Crosby M, et al. The surgical treatment of lymphedema: a systematic review of the contemporary literature (2004-2010). Ann Surg Oncol 2012;19(2):642-51
Feldman S, Bansil H, Ascherman J, et al. Single institution experience with lymphatic microsurgical preventive healing approach (LYMPHA) for the primary prevention of lymphedema 2015;22(10):3296–301.
Papadopoulou MC, Tsiouri I, Salta-Stankova R, Drakou A, Rousas N, Roussaki-Schulze AV, et al. Multidisciplinary lymphedema treatment program. Int J Low Extrem Wounds 2012;11:20-7.
Carl H, Walia G, Bello R, et al. Systematic review of the surgical treatment of extremity lymphedema. J Reconstr Microsurg 2017;33:212.
Narushima M, Mihara M, Yamamoto Y, et al. The intravascular stenting method for treatment of extremity lymphedema with multiconfiguration lymphaticovenous anastomoses. Plast Reconstr Surg 2010;125(3):935–43.
Lu G, DeSourza G, Armer J, et al. Comparing Limb-Volume Measurement Techniques: 3D Models from an Infrared Depth Sensor versus Water Displacement. Innovation an Research in Biomedical Engineering. 2013; Proceedings of the 2013 Internacional Conference e-Health Netwoarking, Applications and Services.
Raju A, Chang DW. Vascularized lymph node transfer for treatment of lymphedema: a comprehensive literature review. Ann Surg. 2015;261(5):1013–23.
Suami H, Chang DW. Overview of surgical treatments for breast cancer-related lymphedema. Plast Reconstr Surg. 2010;126(6):1853–63.
Becker C, Assouad J, Riquet M, Hidden G. Postmastectomy lymphedema: long-term results following microsurgical lymph node transplantation. Ann Surg. 2006;243(3):313–5.
Campisi C, Boccardo F. Microsurgical techniques for lymphedema treatment: derivative lymphatic-venous microsurgery. World J Surg. 2004;28(6):609-13.
Mahrer A, Ramchandani P, Trerotola SO, Shlansky-Goldberg RD, Itkin M. Sclerotherapy in the management of postoperative lymphocele. J Vasc Interv Radiol 2010;21:1050-1053
Akhan O, Karcaaltincaba M, Ozmen MN, Akinci D, Karcaaltincaba D, Ayhan A. Percutaneous transcatheter ethanol sclerotherapy and catheter drainage of postoperative pelvic lymphoceles. Cardiovasc Intervent Radiol 2007;30:237- 240
Zuther JE, Norton S, editors. Lymphedema Management: The Comprehensive Guide for Practitioners. 3rd ed. Sttuttgard: ThiemeVerlag KG; 2013. p. 165-342.
Ridner SH. Pathophysiology of lymphedema. Semin Oncol Nurs 2013;29:4-11.
Lee EW, Shin JH, Ko HK, Park J, Kim SH, Sung KB. Lymphangiography to treat postoperative lymphatic leakage: a technical review. Korean J Radiol. 2014;15(6):724-732.
Sagen A, Kåresen R, Risberg MA. Physical activity for the affected limb and arm lymphedema after breast cancer surgery. A prospective, randomized controlled trial with two years follow-up. Acta Oncol. 2009;48(8):1102–10.
Ahmed RL, Thomas W, Yee D, Schmitz KH. Randomized controlled trial of weight training and lymphedema in breast cancer survivors. J Clin Oncol. 2006;24(18):2765–72.
Kitai T, Inomoto T, Miwa M, et al. Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer. Breast Cancer 2005;12(3):211–5.
Suami H, Chang DW, Yamada K, et al. Use of indocyanine green fluorescent lymphography for evaluating dynamic lymphatic status. Plast Reconstr Surg 2011;127(3):74e–6e.
Chang DW. Lymphaticovenular bypass for lymphedema management in breast cancer patients: a prospective study. Plast Reconstr Surg 2010;126(3):752–8.
Cheng M-H, Chen S-C, Henry SL, et al. Vascularized groin lymph node flap transfer for postmastectomy upper limb lymphedema: flap anatomy, recipient sites, and outcomes. Plast Reconstr Surg 2013;131(6):1286–98.
Lee GK, Perrault DP, Bouz A, et al. Surgical treatment modalities for lymphedema. J Aesthet Reconstr Surg 2016;2(2).
Olszewski WL, Engeset A: Intrinsic contractility of prenodal lymph vessels and lymph flow in human leg. Am J Physiol 1980;239:H775–H783.
BAIOCCHI, Jaqueline Munaretto Timm. Fisioterapia em oncologia. 1 ed. Curitiba: Appris, 2017
