Lymphedema

A Concise Compendium of Theory and Practice
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Professor B.B. Lee began his career as a founding member of the transplant and vascular surgery program at Georgetown University, Washington, D.C., in 1979. He is now better known as a leading vascular surgeon in the field of veno-lymphatic disorders in the U.S. and a world authority on congenital vascular malformation and lymphedema. Prof. Lee, a disciple of the late David Hume of the Medical College of Virginia (Richmond, Virginia), has also made far-reaching contributions in the field of transplant surgery. During his tenure at Johns Hopkins University as clinical professor of surgery, he established a world-class living-related liver transplantation program in Seoul, Korea, as the founding professor and chairman of the Surgical Sciences Department at Samsung Medical Center and SungKyunKwan University. In recognition of his contributions to vascular surgery, Prof. Lee was named Distinguished Fellow by the Society for Vascular Surgery in the U.S. He has published over 800 original papers and abstracts in addition to more than four dozen book chapters, mainly in the field of vascular malformation and lymphedema. He has also given more than 500 lectures around the world. Prof. Lee has been serving on numerous national and international peer-reviewed journals as an editor as well as a reviewer specializing in the field of vascular malformation and lymphedema. He has played a critical role in introducing vascular malformation into the mainstream of vascular surgery. Consequently, Prof. Lee was invited by the Royal Society of Medicine and the American College of Phlebology Foundation to contribute as guest editor to a special issue of Phlebology on venous malformation in 2007. He was also invited by the American Venous Forum to write a chapter on AV malformation for the Handbook of Venous Disorders. Most notably, he was invited by the Society of Vascular Surgery/Journal of Vascular Surgery editorial board to write the vascular malformation chapter for Rutherford's Vascular Surgery, which remains the leading textbook for vascular surgeons around the world. Recently, both societies invited Prof. Lee back to write for, and update, their new editions. Prof. Lee has served as president or vice president on many national and international societies, including the IUA (International Union of Angiology) and the IUP (International Union of Phlebology). He has been elected to honorary as well as emeritus member status by numerous phlebology and lymphology societies throughout the world. For decades, he has led the IUP in addition to the IUA, boosting the image of both societies through his outstanding academic contributions. He has also successfully organized numerous world consensuses, including the consensuses on Primary Lymphedema and Venous Malformation for the IUP, in addition to the consensuses on AV malformation for the IUA. Until recently, Prof. Lee served on the ISVS (International Society of Vascular Surgery) as Vice President and also the American Specialty Board of Venous and Lymphatic Disease as a member of the Board of Directors, to promote this new specialty throughout the U.S. In 2011, Prof. Lee moved from Georgetown University to George Washington University, Washington, D.C., to provide worldwide services as the director of the Center for Vascular Malformation and Lymphedema. He also regularly contributes to the Uniformed Services University/Walter Reed Army Medical Center as Adjunct Professor and to Johns Hopkins University as Visiting Professor in addition to Georgetown University.

Dr. Stanley Rockson is the Allan and Tina Neill Professor of Lymphatic Research and Medicine at Stanford University School of Medicine. After earning his medical degree from Duke University School of Medicine, Dr Rockson completed his internship and residency training in internal medicine at Brigham and Women's Hospital of Harvard

The authors have been selected for their acknowledged international stature in the fields of lymphatic biology, medicine and surgery

Foreword: J. Lionel Villavicencio  

 

Preface:  BB Lee and Stanley Rockson 

Section I - Introduction

1.                  General Overview

Byung-Boong Lee   and Stanley G. Rockson 

 

2     Etiology and Classification of Lymphatic Disorders

     Stanley G. Rockson

 

3        Hereditary and Familial Lymphedemas

 Peter Mortimer

 

Section II - Embryology, Anatomy, & Histology

 

4. Lymphatic Vascular Development and Lymphangiogenesis

Stanley G. Rockson

 

5. Anatomy of the Lymphatic System and its Structural Disorders

Hiroo Suami

 

Section III - Physiology, Pathophysiology and Lymphodynamics          

 

6.  General Overview

Stanley G. Rockson

 

7. Lymphodynamics

Stanley G. Rockson

 

8. Physiology- Lymph Flow

 David C Zawieja

 

9. Biomechanics of the Lymphatic Circulation

James Moore

 

10. Pathology & Histochemistry

Waldemar Olszewski

 

11. The Cellular and Molecular Composition of Lymph

Laura Santambrogio

 

Section IV - Clinical Diagnosis   

 

12.  General Overview

 Stanley G. Rockson 

 

13.  Clinical Staging

Sandro Michelini

 

14.  Combined Clinical and Laboratory (Lymphoscintigraphic) Staging

Byung-Boong Lee, James Laredo, and Richard Neville

 

15.  Diagnostic considerations in latent and early stage lymphedema

Leigh Ward   

 

16. Cutaneous manifestations of edema

Peter Mortimer

 

17.  Differential Diagnosis of Edema

Stanley Rockson

 

18. Differential Diagnosis: Venous Edema

Eri Fukuyama

 

19.  Differential Diagnosis: Lipedema

Gyözö Szolnoky

 

 

 

 

Section V - Laboratory/Imaging Diagnosis

 

20.  General Guidelines

Andrzej Szuba

 

21.  Radionuclide Lymphoscintigraphy

Pierre Bourgeois

 

22.  Duplex ultrasonography

Attilio Cavezzi

 

23.  Oil Contrast Lymphangiography

J. Lionel Villavicencio

 

24.  Fluorescent microlymphangiography

Claudio Allegra

 

25. Near Infrared Fluorescent Lymphography

Takumi Yamamoto

 

26. MR Lymphangiography 

NingFei  Liu

 

27. Combined role of the lymphoscintigraphy, Xray Computed Tomography, Magnetic Resonance Imaging, and Positron Emission Tomography in the management of lymphedematous disease

Pierre Bourgeois

 

28.  Alternative assessment & measurement tools

Neil Piller

 

 

Section VI - Physical and Medical Management

 

29. General Overview

Stanley G. Rockson

 

30. Physiological principles of physiotherapy

Ethel Földi   

 

31.  Complex Decongestive Therapy

Kristiane Gordon

 

32.  Compression Therapy

Hugo Partsch

 

33.  Intermittent Pneumatic Compression Therapy

Stanley G. Rockson

 

34.  Other contemporary treatment modalities

Neil Piller

 

35.  Medical treatment options

Stanley G. Rockson

 

36. Diagnosis and Managment of Infection in Lymphedema

Waldemar Olszewski

 

37. The prospect for genetic and growth factor therapies

Stanley G. Rockson

 

38.   Compliance and Quality of Life

 Sheila  Ridner

 

39. Lymphedema Healthcare Delivery

Jane Armer

 

Section VII - Practical issues in the Physiotherapeutic Approach to Lymphedema

 

40. Lower limb lymphedema

Gyözö Szolnoky 

 

41. Upper limb lymphedema

Robert Damstra

 

42. Head, Face, & neck lymphedema

Anne-Marie Vaillant-Newman and Stanley G. Rockson

 

43. Genital lymphedema

Stéphane Vigne

 

Section VIII - Surgical treatment - Reconstructive Surgery

 

44. General Overview  

Peter Gloviczki

             

45. Principles of Patient Selection for Surgical Management

Joseph Dayan

 

46.  Lympho-venous bypass surgery

Francesco Boccardo and Corradino Campisi

 

47. Lympho-lymphatic bypass surgery

Ruediger Baumeister

 

48. Lymph node-to-venous bypass and other related reconstructive surgery

Gurusamy Manokaran

 

49. Lymph nodes transplantation

Dung Nguyen and Corinne Becker

 

50. Surgical Management of Lipedema

Mark Smith

  

51. Controversies and Current Dilemmas in Reconstructive Surgery for Lymphedema

Byung-Boong Lee, James Laredo, and Richard Neville

 

52. Future prospects in lymphatic reconstructive surgery

David Chang

 

Section IX - Surgical treatment: Excisional and Debulking Techniques <

 

53. Contemporary indications and controversies in excisional surgery

Byung-Boong Lee, James Laredo, and Richard Neville

 

54. General Principles for debulking/excisional surgery

Gurusamy Manokaran

 

55.  Suction-Assisted Lipectomy for the Management of  Lymphedema

Håkan Brorson 

 

Section X - Congenital Vascular Malformation with Lymphatic Involvement

 

56.  Primary lymphedema and Lymphatic Malformation

Byung-Boong Lee, James Laredo and Richard Neville

 

57.  Syndromic Lympedema and Complex Vascular Malformations with Lymphatic Involvement

   Francine Blei

 

58. An Atlas of Neonatal and Infantile Lymphedema

Cristobal Miguel Papendieck and Miguel Amore   

 

Section XII - Management of Chyle Reflux and Effusions

 

59. Pathophysiology and Medical Management of Chylous Disorders

Francine Blei

 

 

60. Surgical management of Chylous Reflux

Steve Fishman

 

61. Endovascular Catheter-based Management of Chylous Effusions

Max Itkin

 

Section XII - Lymphatic Filariasis

 

62. Epidemiology

LeAnn Fox

 

63. Etiology & Pathophysiology

Thomas Nutman

 

64. Clinical Overview- Diagnosis & Management

Gurusamy Manokaran

 

Section XIV - Oncology and lymphedema

 

65.  Breast cancer

Sharon L. Kilbreath

 

66.  Lower extremity cancers

Mi-Joung Lee  and Stanley G. Rockson

 

67.  Radiation Complication

Kathleen Horst

 

Section - XV - Phlebolymphedema

 

68. Diagnosis and Management of Primary Phlebolymphedema

James Laredo and Byung-Boong Lee  

 

69. Diagnosis and Management of Secondary Phlebolymphedema

Attilio Cavezzi

 

70. Management of phlebolymphedema ulcer

 Sergio Gianesini (and Erica Menegatti)

Epilogue

BB Lee & Stan Rockson

The second edition of this book serves as a central source of theoretical and practical knowledge to optimize the evaluation and treatment of patients with lymphedema. The book covers all aspects of the disease from anatomical and histological features to diagnosis as well as physical/medical and surgical management of the disease.

Updated from the first edition to reflect the substantial progress in diagnostics, medical care and surgical intervention for this patient population, this volume has been reorganized to meet today's practice requirements. It addresses the challenges faced by clinicians in the management of chronic lymphedema enabling them to meet the medical needs of this large patient community.

Edited by world leaders in Vascular Medicine and Surgery, this comprehensive volume provides clear, concise background and recommendations in an easy-to-use format. It is a valuable reference tool for clinical practitioners (physicians/nurse practitioners/technicians) who wish to deliver state-of-the-art health care to their patients with lymphatic and venous disorders.

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