{"id":122,"date":"2014-02-19T07:28:40","date_gmt":"2014-02-19T07:28:40","guid":{"rendered":"http:\/\/lymphoedemacenter.com\/?page_id=122"},"modified":"2022-01-05T10:23:51","modified_gmt":"2022-01-05T10:23:51","slug":"arm-lymphedema","status":"publish","type":"page","link":"https:\/\/lymphoedemacenter.com\/?page_id=122","title":{"rendered":"Arm lymphedema"},"content":{"rendered":"<h2 class=\"wp-block-heading\">Iatrogenic edema of the arm<\/h2>\n\n\n\n<p class=\"text-justify\"><a class=\"glossaryLink\"  title=\"Glossary: Iatrogenic\"  aria-describedby=\"tt\"  data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Iatrogenic&lt;\/div&gt;&lt;div class=glossaryItemBody&gt;Relating to illness or caused by medical examination or treatment&lt;\/div&gt;\"  href=\"https:\/\/lymphoedemacenter.com\/?glossary=iatrogenic\"  data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]'  tabindex='0' role='link'>Iatrogenic<\/a> lymphedema of the arm is lymphedema of the arm caused by treatment for a disease (such as breast cancer) or by previous surgery.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Diagnostic<\/h2>\n\n\n\n<ul class=\"text-justify wp-block-list\"><li>Lymphatic MRI is the test of choice for determining the indication for surgery, new lymph vessels, transplanted lymph nodes, and changes in lymph vessel growth.<\/li><li>The results observed by isotopic lymphangiography show the absorption of the contrast fluid but, compared to the lymphatic MRI, they give little information on the rest of the network<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><a href=\"http:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/2.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/2-1030x331.jpg\" alt=\"\" class=\"wp-image-2976\" width=\"350\" height=\"113\" srcset=\"https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/2-1030x331.jpg 1030w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/2-300x97.jpg 300w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/2.jpg 1035w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/2-300x97@2x.jpg 600w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\"\/><\/a><\/figure><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Surgical Treatment<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Lymph Nodes Transfer (LNT)<\/h3>\n\n\n\n<p class=\"text-justify\"><strong>Autologous Lymph Nodes Transfer (<a class=\"glossaryLink\"  title=\"Glossary: ALNT\"  aria-describedby=\"tt\"  data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;ALNT&lt;\/div&gt;&lt;div class=glossaryItemBody&gt;Stands for Autologous Lymph Nodes Transplantation, a surgical procedure where healthy lymph nodes from a donor site are transferred to the lymphedema affected area to reconstruct the damaged lymphatic system.&lt;\/div&gt;\"  href=\"https:\/\/lymphoedemacenter.com\/?glossary=alnt\"  data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]'  tabindex='0' role='link'>ALNT<\/a>),<\/strong> also called microsurgical vascularized lymph nodes transfer (<strong>VLNT<\/strong>) involves transferring a few healthy lymph nodes from one site to the affected area to restore the lymphatic function in the limb.<\/p>\n\n\n\n<p class=\"text-justify\">ALNT has many <a title=\"Treatment options for lymphedema\" href=\"\/?page_id=28#alnt-indications\">advantages<\/a>. Check out <a title=\"Treatment options for lymphedema\" href=\"\/?page_id=28#alnt-candidate\">who is a good candidate<\/a>. All details about<a href=\"#alnt-details\"> ALNT and iatrogenic arm lymphedema <\/a>are here below.<\/p>\n\n\n\n<ul class=\"text-justify wp-block-list\"><li>40% final standardization<\/li><li>98% improvement<\/li><li>2% without result<\/li><li>No worsening of lymphoedema<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Results<\/h3>\n\n\n\n<div class=\"wp-block-image wp-image-1713 size-full\"><figure class=\"aligncenter size-large is-resized\"><a href=\"http:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/annt-normal-activity.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/annt-normal-activity-1030x510.jpg\" alt=\"\" class=\"wp-image-2828\" width=\"350\" height=\"173\" srcset=\"https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/annt-normal-activity-1030x510.jpg 1030w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/annt-normal-activity-300x148.jpg 300w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/annt-normal-activity.jpg 1035w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/annt-normal-activity-300x148@2x.jpg 600w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\"\/><\/a><figcaption><em>&#xA0;Normal activity before and 1 year after ANLT no sleeves, no physiotherapy. (D. Giardini)<\/em><\/figcaption><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image wp-image-1716\"><figure class=\"aligncenter size-large is-resized\"><a href=\"http:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Preop-and-10-years-after-lymphnodes-tranaplantation.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Preop-and-10-years-after-lymphnodes-tranaplantation-1030x586.jpg\" alt=\"\" class=\"wp-image-2837\" width=\"350\" height=\"199\" srcset=\"https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Preop-and-10-years-after-lymphnodes-tranaplantation-1030x586.jpg 1030w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Preop-and-10-years-after-lymphnodes-tranaplantation-300x171.jpg 300w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Preop-and-10-years-after-lymphnodes-tranaplantation.jpg 1035w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Preop-and-10-years-after-lymphnodes-tranaplantation-300x171@2x.jpg 600w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\"\/><\/a><figcaption><em>The growth of new lymphatic vessels is visible on MRI 1 year after lymph node transfer in the axillary area.Complete normalisation<\/em><\/figcaption><\/figure><\/div>\n\n\n\n<ul class=\"text-justify wp-block-list\"><li><strong>Elephantiasis <\/strong>over 20 years old, with chronic infections, can be improved (as in this case, 4 years after LNT)<\/li><li>Significant improvement in all cases but never complete recovery<\/li><li>98% improvement, but never complete normalization<\/li><li>Decrease in infections<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Moderate lymphedema<\/strong><\/h3>\n\n\n\n<ul class=\"text-justify wp-block-list\"><li>Can be healed simply by adding certain knots like here.<\/li><li>Scarring can be observed in these cases in 70% and improvement in all cases. The results will be stable after 1 year.<\/li><\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Lymphedema stage 2 and 3 (more advanced)<\/h4>\n\n\n\n<p class=\"text-justify\">&#x2022; Can be cured, but the combination with liposculpture to remove fatty deposits is important. It can be made the same assignment or later. The results will be better if the fibrous tissue is not too thick. operated as soon as possible, when the lymphoMRI shows no drainage. The normalization will be 40% of the cases, and the others will be improved by more than 50%<\/p>\n\n\n\n<div class=\"wp-block-image wp-image-1722\"><figure class=\"aligncenter size-large is-resized\"><a href=\"http:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/extreme-fibrotic-lymphoedema.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/extreme-fibrotic-lymphoedema-1030x482.jpg\" alt=\"\" class=\"wp-image-2831\" width=\"350\" height=\"164\" srcset=\"https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/extreme-fibrotic-lymphoedema-1030x482.jpg 1030w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/extreme-fibrotic-lymphoedema-300x140.jpg 300w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/extreme-fibrotic-lymphoedema.jpg 1035w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/extreme-fibrotic-lymphoedema-300x140@2x.jpg 600w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\"\/><\/a><figcaption><em>Extreme fibrotic lymphoedema, on the right one year after the operation.<\/em><\/figcaption><\/figure><\/div>\n\n\n\n<h4 class=\"wp-block-heading\">Lymphoedema stage 4<\/h4>\n\n\n\n<ul class=\"text-justify wp-block-list\"><li>Can be cured also in some cases, but it becomes difficult and 2 flaps can be mandatory plus liposculpture or local excisions must be combined<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image wp-image-1725\"><figure class=\"aligncenter size-large is-resized\"><a href=\"http:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Preop-no-myphatic-vessesl.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Preop-no-myphatic-vessesl-1030x515.jpg\" alt=\"\" class=\"wp-image-2840\" width=\"350\" height=\"175\" srcset=\"https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Preop-no-myphatic-vessesl-1030x515.jpg 1030w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Preop-no-myphatic-vessesl-300x150.jpg 300w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Preop-no-myphatic-vessesl.jpg 1035w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Preop-no-myphatic-vessesl-300x150@2x.jpg 600w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\"\/><\/a><figcaption><em>Preop no myphatic vessesl<\/em><\/figcaption><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image wp-image-1728\"><figure class=\"aligncenter size-large is-resized\"><a href=\"http:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Post-op-new-lymphatic-vessels.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Post-op-new-lymphatic-vessels-1030x433.jpg\" alt=\"\" class=\"wp-image-2834\" width=\"350\" height=\"148\" srcset=\"https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Post-op-new-lymphatic-vessels-1030x433.jpg 1030w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Post-op-new-lymphatic-vessels-300x126.jpg 300w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Post-op-new-lymphatic-vessels.jpg 1035w, https:\/\/lymphoedemacenter.com\/wp-content\/uploads\/2021\/12\/Post-op-new-lymphatic-vessels-300x126@2x.jpg 600w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\"\/><\/a><figcaption><em>Post op new lymphatic vessels<\/em><\/figcaption><\/figure><\/div>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Effect on infections<\/strong><\/h4>\n\n\n\n<ul class=\"text-justify wp-block-list\"><li>Decrease in chronic infections in 90% of cases<\/li><li>Complete disappearance in 68% of cases<\/li><\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Effect on pain<\/strong><\/h4>\n\n\n\n<ul class=\"text-justify wp-block-list\"><li>The pain that appears after an adenomectomy can be eliminated after surgery if the neuromas are treated.<\/li><li>Pain and decreased tenderness in plexopathies may be improved, but improvement depends on damage to the plexus. Progressive degeneration of the nerves is stopped, but never really resolved<\/li><li>Tendon transfer may be performed later to restore some functionality to the arm in cases of partial paralysis of the arm and hand.<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Potential complications<\/strong><\/h3>\n\n\n\n<p class=\"text-justify\"><em>The donor site does NOT create lymphedema if the dissection is well done.<\/em><\/p>\n\n\n\n<p class=\"text-justify\">The <a class=\"glossaryLink\"  title=\"Glossary: Flap\"  aria-describedby=\"tt\"  data-cmtooltip=\"&lt;div class=glossaryItemTitle&gt;Flap&lt;\/div&gt;&lt;div class=glossaryItemBody&gt;Flap surgery is a technique in plastic and reconstructive surgery where any type of tissue is lifted from a donor site and moved to a recipient site with its own blood vessels.&lt;\/div&gt;\"  href=\"https:\/\/lymphoedemacenter.com\/?glossary=flap\"  data-gt-translate-attributes='[{\"attribute\":\"data-cmtooltip\", \"format\":\"html\"}]'  tabindex='0' role='link'>flap<\/a> is NOT inguinal, but UPPER the inguinal fold and the 3.4 nodes removed are the lumbar area nodes and NOT THE LEG. But the anatomy should be well known and the surgeon should have good experience with this flap (and this flap has been known for 40 years for hand reconstruction &ndash; mac gregor flap). Injecting fluorescein into the feet can help prevent the lymph nodes draining from the leg from being removed.<\/p>\n\n\n\n<ul class=\"text-justify wp-block-list\"><li>Seromas at donor sites reduced by restraints<\/li><li>Slight temporary edema at the donor site (0.001%)<\/li><li>Infections in 1% of cases<\/li><li>Flap necrosis 2%<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Lymphovenous anastomosis<\/h3>\n\n\n\n<p class=\"text-justify\"><em>The indications are limited to the early stages of the disease, when there is no fibrosis or sclerosis of the remaining <\/em>lymphatic vessels, and life-long bandages are prescribed. The identification of good lymphatic vessels and the quality of the anastomosis are critical. Maintaining compression is essential to ensure high pressure in the lymphatic system. Many failures have therefore been reported with this technique.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Iatrogenic edema of the arm Iatrogenic lymphedema of the arm is lymphedema of the arm caused by treatment for a disease (such as breast cancer) or by previous surgery. Diagnostic Lymphatic MRI is the test of choice for determining the&#x2026; <\/p>\n","protected":false},"author":4,"featured_media":0,"parent":28,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-122","page","type-page","status-publish","hentry"],"aioseo_notices":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Arm lymphedema - Dr Corinne Becker - Lymphoedema Center<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/lymphoedemacenter.com\/?page_id=122\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Arm lymphedema - Dr Corinne Becker - Lymphoedema Center\" \/>\n<meta property=\"og:description\" content=\"Iatrogenic edema of the arm Iatrogenic lymphedema of the arm is lymphedema of the arm caused by treatment for a disease (such as breast cancer) or by previous surgery. 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