Lymphedema: Classification, diagnosis and therapy

Vascular Medicine

Volumn 3, Issue 2, 1998, Pages 145-156

  Szuba, Andrzej ^a   Rockson, Stanley G ^a,b  

^a STANFORD UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b STANFORD UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Compressive therapy; Lymphedema; Lymphoscintigraphy; Manual lymphatic drainage; Microvascular surgery; Pneumatic compression

Indexed keywords

CLINICAL EXAMINATION; COMPRESSION THERAPY; DISEASE CLASSIFICATION; FILARIASIS; HUMAN; LYMPHEDEMA; LYMPHOGRAPHY; LYMPHOSCINTIGRAPHY; PATHOPHYSIOLOGY; PHYSIOTHERAPY; PRIORITY JOURNAL; REVIEW;

EID: 0031726017     PISSN: 1358863X     EISSN: None     Source Type: Journal    
DOI: 10.1177/1358836x9800300209     Document Type: Review

References (158)

1. Greenlee R, Hoyme H, Witte M, Crowe P, Witte C. Developmental disorders of the lymphatic system. Lymphology 1993; 26(4): 156-68.
2. Cambria RA, Gloviczki P, Naessens JM, Wahner HW. Noninvasive evaluation of the lymphatic system with lymphoscintigraphy: a prospective, semiquantitative analysis in 386 extremities. J Vasc Surg 1993; 18(5): 773-82.
3. Partsch H. Assessment of abnormal lymph drainage for the diagnosis of lymphedema by isotopic lymphangiography and by indirect lymphography. Clin Dermatol 1995; 13: 445-50.
4. Ter SE, Alavi A, Kim CK, Merli G. Lymphoscintigraphy. A reliable test for the diagnosis of lymphedema. Clin Nucl Med 1993; 18(8): 646-54.
5. Brautigam P, Vanscheidt W, Foldi E, Krause T, Moser E. The importance of the subfascial lymphatics in the diagnosis of lower limb edema: investigations with semiquantitative lymphoscintigraphy. Angiology 1993; 44(6): 464-70.
6. Case TC, Witte CL, Witte MH, Unger EC, Williams WH. Magnetic resonance imaging in human lymphedema: comparison with lymphangioscintigraphy. Magn Reson Imaging 1992; 10(4): 549-58.
7. Consensus document of the International Society of Lymphology Executive Committee. The diagnosis and treatment of peripheral lymphedema. Lymphology 1995; 28(3): 113-17.
8. Duewell S, Hagspiel KD, Zuber J, von Schulthess GK, Bollinger A, Fuchs WA. Swollen lower extremity: role of MR imaging. Radiology 1992; 184(1): 227-31.
9. Haaverstad R, Nilsen O, Myhre HO, Saether OD, Rinck PA. The use of MRI in the investigation of leg oedema. Eur J Vasc Surg 1992; 6(2): 124-29.
10. Haaverstad R, Nilsen G, Rinck PA, Myhre HO. The use of MRI in the diagnosis of chronic lymphedema of the lower extremity. Int Angiol 1994; 13(2): 115-18.
11. Werner GT, Rodiek SO. Value of nuclear magnetic resonance tomography in leg edema of unknown origin. Preliminary report. Z Lymphol 1993; 17(1): 2-5.
12. Weissleder R, Heautot J, Schaffer BK et al. MR lymphography. study of a high-efficiency lymphotropic agent. Radiology 1994; 191(1): 225-30.
13. Vassalloo P, Matei C, Heston W, McLachlan S, Koutcher J, Castellino R. AMI-227-enhanced MR Iymphography: usefulness for differentiating reactive from tumor-bearing lymph nodes. Radiology 1994; 193: 501-06.
14. Okuhata Y, Xia T, Urahashi S, Arimizu N. MR Iymphography: first clinical application to human. Nippon Acta Radiologica 1994; 54(5): 410-12.
15. Vaughan BF. CT of swollen legs. Clin Radiol 1990; 41(1): 24-30.
16. Collins CD, Mortimer PS, D'Ettorre H, A'Hern RP, Moskovic EC. Computed tomography in the assessment of response to limb compression in unilateral lymphoedema. Clin Radiol 1995; 50(8): 541-44.
17. Bruna J. Computerized tomography, xeroradiography, lymphography, and xerolymphography in diagnosis of lymph stasis. In: Olszewski W ed. Lymph stasis: pathophysiology, diagnosis and treatment. Boca Raton, FL: CRC Press, 1991: 412-43
18. Gan JL, Zhang DS, Fu KD, Luo JC, Chen H. Indirect lymphography with Isovist-300 in various forms of lymphedema. Chin Med J (Engl) 1991; 104(1): 49-53.
19. Schultz-Ehrenburg U, Niederauer HH, Tiedjen KU. Stasis papillomatosis. Clinical features, etiopathogenesis and radiological findings. J Dermatol Surg Oncol 1993; 19(5): 440-46.
20. Servelle M. La lymphographie, moyen d'etude de la physiopathologie des grosses jambes. Rev Chir 1944; 82: 251-58.
21. Kinmonth JB. Lymphangiography in man. Clin Sci 1952; 11: 13-20.
22. Kinmonth JB, Taylor GW, Tracy GD, Marsh JD. Primary Lymphoedema. Clinical and lymphangiographic studies of a series of 107 patients in which the lower limbs were affected. B J Surg 1957; 45(189): 1-10.
23. Gniadecka M. Localization of dermal edema in lipodermatosclerosis, lymphedema, and cardiac insufficiency. J Am Acad Dermatol 1996; 35: 37-41.
24. Browse NL, Stewart G. Lymphedema: pathophysiology and classification. J Cardiovasc Surg 1985; 26: 91-106.
25. Nonne MH. Elephantiasis congenita. Dtsch Med Wockenschr 1890; 16: 1124.
26. Milroy WF. undescribed variety of hereditary oedema. NY Med J 1892; 56: 505-08.
27. Milroy WF. Chronic hereditary edema: Milroy's disease. JAMA 1928; 91: 1172-74.
28. Mucke J, Hoepffner W, Scheerschmidt G, Gornig H, Beyreiss K. Early onset lymphoedema, recessive form - a new form of genetic lymphedema syndrome. Eur J Pediatr 1986; 145: 195-98.
29. Dahlberg PJ, Borer WZ, Newcomer KL, Yutuc WR. Autosomal or X-linked recessive syndrome of congenital lymphedema, hypoparathyroidism, nephropathy, prolapsing mitral valve and brachytelephalangy. Am J Med Genet 1983; 16: 99-104.
30. Wolfe JHN, Knmonth JB. The prognosis of primary lymphedema of the lower limbs. Arch Surg 1981; 116: 1157-60.
31. Allen EV. Lymphedema of the extremities. Classification, etiology and differential diagnosis. A study of three hundred cases. Arch Intern Med 1934; 54: 606-24.
32. Smeltzer DM, Stickler GB, Schirger A. Primary lymphedema in children and adolescents: a follow-up study and review. Pediatrics 1985; 76(2): 206-18.
33. Toro-Sola MA. Distichiasis-lymphedema syndrome and the Turner phenotype. Bol Assoc Med PR 1991; 83(12): 543-44.
34. Hall JG, Gilchrist DM. Turner syndrome and its variants. Pediatr Clin North Am 1990; 37(6): 1421-40.
35. Erickson RP, Hudgins L, Stone JF, Schmidt S, Wilke C, Glover TW. A 'balanced' Y; 16 translocation associated with Turner-like neonatal Iymphedema suggests the location of a potential anti-Turner gene on the Y chromosome. Cytogenet Cell Genet 1995; 71(2): 163-67.
36. Cordasco EM, Jr, Beder S, Coltro A, Bavbek S, Gurses H, Mehta AC. Clinical features of the yellow nail syndrome. Cleve Clin J Med 1990; 57(5): 472-76.
37. Fields CL, Roy TM, Ossorio MA, Mercer PJ. Yellow hail syndrome: a perspective. J Ky Med Assoc 1991; 89(11): 563-65.
38. Govaert P, Leroy JG, Pauwels R et al. Perinatal manifestions of maternal yellow nail syndrome. Pediatrics 1992; 89(6): 1016-18.
39. Schirger A, Harrison EG, Janes JM. Idiopathic Iymphedema. Review of 131 cases. JAMA 1962; 182: 124-32.
40. Gough MH. Primary Iymphedema: clinical and lymphographic studies. Br J Surg 1966; 53(11): 917-25.
41. Allen EV, Ghormley RK. Lymphedema of the extremities: etiology, classification and treatment; report of 300 cases. Ann Intern Med 1935; 9: 516.
42. Servelle M. Surgical treatment of Iymphedema: a report on 652 cases. Surgery 1987; 101(4): 485-95.
43. Anon. Lymphatic filariasis - tropical medicine's origin will not go away [Editorial]. Lancet 1987; 1: 1409.
44. Segerstrom K, Bjerle P, Graffman S, Faystrom A. Factors that influence the incidence of brachial oedema after treatment of breast cancer. Scands J Plast Reconstr Surg Hand Surg 1992; 26(2): 223-27.
45. Schunemann H, Willich N. Secondary Iymphedema of the arm following primary therapy of breast carcinoma. Zentralbl Chir 1992; 117(4): 220-25.
46. Treves N. An evaluation of the etiological factors of Iymphedema following radical mastectomy: an analysis of 1007 cases. Cancer 1957; 10: 444-59.
47. Osteen RT, Smith BL. Results of conservative surgery and radiation therapy for breast cancer. Surg Clin North Am 1990; 70(5): 1005-21.
48. Werner RS, McCormick B, Petrek J et al. Arm edema in conservatively managed breast cancer: obesity is a major predictive factor. Radiology 1991; 180(1): 177-84.
49. Goltner E, Gass P, Hass J, Schneider P. The importance of volumetry, lymphoscintigraphy and computer tomography in the diagnosis of brachial edema after mastectomy. Lympholagy 1988; 21(3): 134-43.
50. Carvalho JP, Souen JS, Carramao SDS, Yeu WL, Pinotti JA. Wertheim-Meigs radical hysterectomy. Rev Paul Med 1994; 112(2): 539-42.
51. Fiorica JV, Roberts WS, Greenberg H, Hoffman MS, LaPolla JP, Cavanagh D. Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy. Gynecol Oncol 1990; 36(3): 343-47.
52. Haberthur F, Almendral AC, Ritter B. Therapy of vulvar carcinoma. Eur J Gynaecol Oncol 1993; 14(3): 218-27.
53. Werngren-Elgstrom M, Lidman D. Lymphoedema of the lower extremities after surgery and radiotherapy for cancer of the cervix. Scand J Plast Reconstr Surg Hand Surg 1994; 28(4): 289-93.
54. Soisson AP, Soper JT, Clarke-Pearson DL, Berchuck A, Montana G, Creasman WT. Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer. Gynecol Oncol 1990; 37(3): 390-95.
55. Haaverstad R, Johnsen H, Saether OD, Myhre HO. Lymph drainage and the development of post-reconstructive leg oedema is not influenced by the type of inguinal incision. A prospective randomised study in patients undergoing femoropopliteal bypass surgery. Eur J Vasc Endovasc Surg 1995; 10(3): 316-22.
56. Hidden G. Some recent, or claiming to be recent, data on the superficial lymphatic circulation of the limbs. J Mal Vasc 1990; 15(2): 149-51.
57. Smith RD, Spittell JA, Schirger A. Secondary lymphedema of the leg: its characteristics and diagnostic implications. JAMA 1963; 185(2): 116-18.
58. Lymphatic filariasis: the disease and its control. Fifth report of the WHO Expert Committee on Filariasis. WHO Technical Report Series 821. Geneva: World Health Organization, 1992.
59. Pani SP, Srividya A. Clinical manifestations of bancroftian filariasis with special reference to lymphedema grading. Indian J Med Res 1995; 102: 114-18.
60. Pani SP, Krishnamoorthy K, Rao AS, Prathiba J. Clinical manifestations in Malayan filariasis infection with special reference to lymphoedema grading. Indian J Med Res 1990; 91: 200-07.
61. Srividya A, Pani SP, Rajagopalan PK, Bundy DA, Grenfell BT. The dynamics of infection and disease in bancroftian filariasis. Trans R Soc Trop Med Hyg 1991; 85(2): 255-59.
62. Olszewski WL, Jamal S, Manokaran G, Lukomska B, Kubicka U. Skin changes in filarial and non-filarial lymphoedema of the lower extremities. Trop Med Parasitol 1993; 44(1): 40-44.
63. Olszewski W, Jamal S. Skin bacterial factor in progression of filarial lymphedema. Lymphology 1994; 27(3): 148-49.
64. Dacre JB, Scott DL, Huskisson EC. Lymphoedema of the limbs as an extra-articular feature of rheumatoid arthritis [see comments]. Ann Rheum Dis 1990; 49(9): 722-24.
65. Gschwind C, Pfeiffer KM. Rheumatoid lymphedema: a case report. J Hand Surg (Am) 1993; 18(6): 992-24.
66. Kiely PD, Joseph AE, Mortimer PS, Bourke BE. Upper limb lymphedema associated with polyarthritis of rheumatoid type. J Rheamatol 1994; 21(6): 1043-45.
67. Lacroix HR, Gruwez JA, Casteels-Van Daele MC, Dequeker J. Lymphedema of the leg associated with rheumatoid arthritis. Lymphology 1991; 24(2): 68-70.
68. Sant SM, Tormey VJ, Freyne P, Casey EB. Lymphatic obstruction in rheumatoid arthritis. Clin Rheumatol 1995; 14(4): 445-50.
69. Minari C, Cecconami L, Fioravanti A, Montemarani M, Scola C, Marcolongo R. Lymphoedema of the limbs in rheumatoid arthritis. Clin Rheumatol 1994; 13(3): 464-69.
70. Mulherin DM, FitzGerald O, Bresnihan B. Lymphedema of the upper limb in patients with psoriatic arthritis. Semin Arthritis Rheum 1993; 22(5): 350-56.
71. Bull RH, Gane JN, Evans JE, Joseph AE, Mortimer PS. Abnormal lymph drainage in patients with chronic venous leg ulcers. J Am Acad Dermatol 1993; 28(4): 585-90.
72. Guex JJ. Physiopathology of post-thrombotic syndrome. Update 1994. J Mal Vasc 1994; 19(1): 12-16.
73. Larcos G, Wahner HW. Lymphoscintigraphic abnormalities in venous thrombosis [clinical conference]. J Nucl Med 1991; 32(11): 2144-48.
74. Bilancini S, Lucchi M, Tucci S, Eleuteri P. Functional lymphatic alterations in patients suffering from lipedema. Angiology 1995; 46(4): 333-39.
75. Mallon EC, Ryan TJ. Lymphedema and wound healing. Clin Dermatol 1994; 12(1): 89-93.
76. Bollinger A. Microlymphatics of human skin. Int J Microcirc Clin Exp 1993; 12(1): 1-15.
77. Mozes M, Papa MZ, Karasik A, Reshef A, Adar R. The role of infection in postmastectomy lymphedema. Surg Annu 1982; 14: 73-83.
78. Simon MS, Cody RL. Cellulitis after axillary lymph node dissection for carcinoma of the breast. Am J Med 1992; 93(5): 543-48.
79. Binnick AN, Klein RB, Baughman RD. Recurrent erysipelas caused by group B streptococcus organism. Arch Dermatol 1980; 116(7): 798-99.
80. Krywonis N, Kaye VN, Lynch PJ. Cryptococcal cellulitis in congenital lymphedema. Int J Dermatol 1990; 29(1): 41-44.
81. Brook I, Frazier EH. Clinical features and aerobic and anaerobic microbiological characteristics of cellulitis. Arch Surg 1995; 130(7): 786-92.
82. Olszewski W, Jamal S. The role of antibiotics in control of progression of lymphedema. In: Network NL ed. The Second National Lymphedema Network Conference. Burlingame, California, 1996.
83. Hook EW, Hooton TM, Horton CA et al. Microbiologie evaluation of cutaneous cellulitis in adults. Arch Intern Med 1986; 146: 295-97.
84. Van Scoy RE, Wilkowske CJ. Prophylactic use of antimicrobial agents in adult patients [see comments]. Mayo Clin Proc 1992; 67(3): 288-92.
85. Liu NF, Olszewski W. The influence of local hyperthermia on lymphedema and lymphedematous skin of the human leg. Lymphology 1993; 26(1): 28-37.
86. Casley-Smith JR, Morgan RG, Piller NB, Treatment of lymphedema of the arms and legs with 5,6-benzo-[alpha]-pyrone. N Engl J Med 1993; 329(16): 1158-63.
87. Foldi E. Prevention of dermatolymphangioadenitis by combined physiotherapy of the swollen arm after treatment of breast cancer. Lymphology 1996; 29(3): 91-94.
88. O'Brien BM, Mellow CG, Khazanchi RK, Dvir E, Kumar V, Pederson WC. Long-term results after microlymphaticovenous anastomoses for the treatment of obstructive lymphedema. Plast Reconstr Surg 1990; 85(4): 562-72.
89. Pappas CJ, O'Donnell TF Jr. Long-term results of compression treatment for lymphedema. J Vasc Surg 1992; 16(4): 555-62. [Also see discussion, 562-64].
90. Stewart FW, Treves N. Lymphangiosarcoma in post-mastectomy lymphoedema. Cancer 1948; 1: 64.
91. Brady MS, Garfein CF, Petrek JA, Brennan MF. Post-treatment sarcoma in breast cancer patients. Ann Surg Oncol 1994; 1(1): 66-72.
92. Gregl A, Pavic S, Pavic Z, Schauer A, Wilke C, Zinn H. Stewart-Treves syndrome of the edematous arm following breast canccer operation. Z Lymphol 1988; 12(2): 66-83.
93. Sordillo PP, Chapman R, Hadju SI, Magill GB, Golbey RB. Lymphangiosarcoma. Cancer 1981; 48(7): 1674-79.
94. Kiricuta IC, Dammrich J. Lymphangiosarcoma of arm after chronic lymphedema: a rare long-term complication after radical mastectomy in breast cancer patients. Case report and overview. Strahlenther Onkol 1993; 169(5): 291-95.
95. Clements WD, Kirk SJ, Spence RA. A rare late complication of breast cancer treatment. Br J Clin Pract 1993; 47(4): 219-20.
96. Pricolo R. Lymphangiosarcoma with postmastectomy edema of the arm. Minerva Chir 1991; 46(1-2): 67-69.
97. Peyron N, Dandurand M, Guillot B. Malignant tumors as complications of lymphedema. J Mal Vasc 1993; 18(4): 293-98.
98. Foldi M. Treatment of lymphedema [Editorial]. Lymphology 1994; 27(1): 1-5.
99. Foldi E, Foldi M, Weissleder H. Conservative treatment of lymphedema of the limbs. Angiology 1985; 36(3): 171-80.
100. Boris M, Weindorf S, Lasinski B, Boris G. Lymphedema reduction by noninvasive complex lymphedema therapy. Oncology 1994; 8(9): 95-106. [Also see disccussion, 109-10.]
101. Foldi E, Foldi M, Clodius I. The lymphedema chaos: a lancet. Ann Plast Surg 1989; 22: 505-15.
102. Morgan RG, Casley-Smith JR, Mason MR, Casley-Smith JR. Complex physical therapy for the lymphoedematous arm. J Hand Surg (Br) 1992; 17(4): 437-41.
103. Asdonk J. Effectiveness, indications and contraindications of manual lymph drainage therapy in painful edema. Z Lymphol 1995; 19(1): 16-22.
104. Wozniewski M. Value of intermittent pneumatic massage in the treatment of upper extremity lymphedema. Pol Tyg Lek 1991; 46(30-31): 550-52.
105. Walby R. Treatment of lymphedema in institutions. Two weeks of in-hospital intensive lymphatic drainage followed by maintenance treatment with a pulsator. Tidsskr Nor Laegeforen 1990; 110(24): 3125-26.
106. Mirolo BR, Bunce IH, Chapman M et al. Psychosocial benefits of postmastectomy lymphedema therapy. Cancer Nurs 1995; 18(3): 197-205.
107. Dittmar A, Krause D. A comparison of intermittent compression with single and multi-chamber systems in treatment of secondary arm lymphedema following mastectomy. Z Lymphol 1990; 14(1): 27-31.
108. Bunce M, Mirolo BR, Hennessy JM, Ward LC, Jones LC. Post-mastectomy lymphoedema treatment and measurement. Med J Aust 1994; 161(2): 125-28.
109. Brunner U, Frei-Fleischlin C. Current status of combined physical decompression therapy in primary and secondary lymphedema of the legs. Vasa 1993; 22(1): 8-14.
110. Zelikowski A, Haddad M, Reiss R. The 'Lympha-Press' intermittent sequential pneumatic device for the treatment of lymphedema: five years of clinical experience. J Cardiovasc Surg 1986; 27: 288-90.
111. Richmond DM, O'Donnell TF, Zelikowski A. Sequential pneumatic compression for lymphedema. Arch Surg 1985; 120: 1116-19.
112. Eliska O, Eliskova M. Are peripheral lymphatics damaged by high pressure manual massage? [see comments]. Lymphology 1995; 28(1): 21-30.
113. Foldi E. Massage and damage Io lymphatics [Editorial; comment]. Lymphology 1995; 28(1): 1-3.
114. Casley-Smith J, Casley-Smith J. Other physical therapy for lymphedema: pumps; heating; etc. In: Casley-Smith J, Casley-Smith J, eds. Lymphedema. Adelaide: The Lymphedema Association of Australia, 1991: 155-159.
115. Boris M, Weindorf S, Lasinski B. The risks of genital lymphedema after pump treatment for lower limb lymphedema. Burlingame, California: The Second National Lymphedema Network Conference, 1996.
116. Balzarini A, Pirovano C, Diazzi G et al. Ultrasound therapy of chronic arm lymphedema after surgical treatment of breast cancer. Lymphology 1993; 26(3): 128-34.
117. Callam M, Ruckley C, Dale J et al. Hazards of compression treatments of the leg; an estimate from Scottish surgeons. BMJ 1998; 295: 1382.
118. Bastien M, Goldstein B, Lesher J et al. Treatment of lymphedema with a multicompartmcntal pneumatic compression device. J Am Acad Dermatol 1989; 20: 853-54.
119. Pittman G. Peroneal nerve palsy following sequential pneumatic compression. JAMA 1989; 261(15): 2201-02.
120. Stemmer R, Marescaux J, Furderer C. Compression treatment of the lower extremities particularly with compression stockings. Hautarzt 1980; 31(7): 355-65.
121. Spence K, Cahall E. Inelastic versus elastic leg compression in chronic venous insufficiency: a comparison of limb size and venous hemodynamics. J Vas Surg 1996; 24: 783-87.
122. Reid T, Thiadens S. Reid sleeve for treatment of lymphedema: results of clinical trial. Burlingame, California: The Second National Lymphedema Network Conference, 1996: 14.
123. Ohkuma M. Lymphedema treated by microwave and elastic dressing. Int J Dermatol 1992; 31(9): 660-63.
124. Chang T, Han L, Gan J, Huang W. Microwave, an alternative to electric heating in the treatment of peripheral lymphedema. Lymphology 1989; 22(1): 20-24.
125. Zhang T, Huang W, Han L, Liu W. Heat and bandage treatment for chronic lymphedema of extremities. Report of 1045 patients. Chin Med J 1984; 97(8): 567-77.
126. Katoh I, Harada K, Tsuda Y et al. Intraarterial lymphocytes injection for treatment of lymphedema. Jpn J Surg 1984; 14: 331-34.
127. Harada M, Amano Y, Matsuzaki K et al. Quantitative evaluation of intraarterial lymphocyte injection therapy for lymph edema using MR imaging. Acta Radiol 1994; 35(5): 405-08.
128. Egawa Y, Sato A, Katoh I, Natori Y, Monden Y. Reduction in arm swelling and changes in protein components of lymphedema fluid after intraarterial injection of autologous lymphocytes. Lymphology 1993; 26(4): 169-76.
129. Yoshizumi M, Katoh I, Yoshida O et al. Intraarterial lymphocyte-injection therapy for lymphedema of the leg: an examination using indium-111 oxine-labeled autologous lymphocytes. Tokushima J Exp Med 1992; 39(3-4): 123-26.
130. Nagata Y, Murata R, Mitsumori M et at. Intraarterial infusion of autologous lymphocytes for the treatment of refractory lymphoedema. Preliminary report. Eur J Surg 1994; 160(2): 105-09.
131. Knight KR, Ritz M, Lepore DA, Booth R, Octigan K, O'Brien BM. Autologous lymphocyte therapy for experimental canine lymphoedema; a pilot study. Aust N Z J Surg 1994; 64(5): 332-37.
132. Casley-Smith JR, Wang CT, Casley-Smith JR, Zi-hai C. Treatment of filarial lymphoedema and elephantiasis with 5,6-benzo-alpha-pyrone (coumarin). BMJ 1993; 307(6911): 1037-41.
133. Casley-Smith JR, Jamal S, Casley-Smith J. Reduction of filaritic lymphoedema and elephantiasis by 5,6 benzo-alpha-pyrone (coumarin), and the effects of diethylcarbamazine (DEC). Ann Trop Med Parasitol 1993; 87(3): 247-58.
134. Knight KR, Hurley JV, Hickey MJ, Lepore DA, O'Brien BM. Combined coumarin and omental transfer treatments for canine proximal obstructive lymphoedema. Int J Exp Pathol 1991; 72(5): 533-42.
135. Egan D, O'Kennedy R, Moran E, Cox D, Prosser E, Thornes RD. The pharmacology, metabolism, analysis, and applications of coumarin and coumarin-related compounds. Drug Metab Rev 1990; 22(5): 503-29.
136. Piller NB. Lymphedema, macrophages and benzopyrones. Lymphology 1980; 13: 109-19.
137. Knight KR, Vairo G, Hamilton JA, Lepore DA. Coumarins: macrophage proteinase production and pinocytosis. Res Exp Med 1992; 192(2): 99-103.
138. Piller NB, Morgan RG, Casley-Smith JR. A double-blind, cross-over trial of O-(beta-hydroxyethyl) rutosides (benzo-pyrones) in the treatment of lymphedema of the arms and legs. Br J Plastic Surgery 1988; 41(1): 444-45.
139. Foldi M. Modern treatment for lymphedema [book review]. Lymphology 1995; 28: 147-49.
140. Dini D, Gozza A, Silvestro S, Cavallari M, Forno G. Sulodexide in the prevention of post-mastectomy lymphedema. Minerva Chir 1995; 50(4): 431-34.
141. Arroyo JF, Cohen ML. Improvement of yellow nail syndrome with oral zinc supplementation. Clin Exp Dermatol 1993; 18(1): 62-64.
142. Sofia P, Cuesta A, Romero H, Martinez FJ, Sastre A. Dietary treatment of lymphedema by restriction of long-chain triglycerides. Angiology 1994; 45(8): 703-07.
143. Campisi C, Boccardo F, Tacchella M. Reconstructive microsurgery of lymph vessels: the personal method of lymphatic-venous-lymphatic (LVL) interpositioned grafted shunt. Microsurgery 1995; 16(3): 161-66.
144. Baumeister RGH. Microsurgical autologous lymph-vessel grafting. In: Olszewski WL ed. Lymph stasis: pathophysiology, diagnosis and treatment. Boca Raton, FL: CRC Press, 1991: 545-52.
145. Olszewski WL. Surgical lympho-venous anastomoses for treatment of lymphedema. In: Olszewski WL ed. Lymph stasis: pathophysiology, diagnosis and treatment. Boca Raton, FL: CRC Press, 1991: 526-36.
146. Campisi C. The autologous grafts in reconstructive microsurgery for lymph stasis. In: Olszewski WL ed. Lymph stasis: pathology, diagnosis and treatment. Boca Raton, FL: CRC Press, 1991: 554-573.
147. Filippetti M, Santoro E, Graziano F, Petric M, Rinaldi G. Modern therapeutic approaches to postmastectomy brachial lymphedema. Microsurgery 1994; 15(8): 604-10.
148. Gloviczki P. Microsurgical lymphovenous anastomosis for treatment of lymphedema: a critical review. J Vasc Surg 1988; 7: 647.
149. Hurst PA, Stewart G, Kinmonth JB, Browse NL. Long term results of the enteromesenteric bridge operation in the treatment of primary lymphoedema. B J Surg 1985; 72(4): 272-74.
150. Savage RC. The surgical management of lymphedema. Surg Gynecol Obstet 1985; 160: 283-89.
151. O'Brien BM, Hickey MJ, Hurley JV et al. Microsurgical transfer of the greater omentum in the treatment of canine obstructive lymphoedema. Br J Plast Surg 1990; 43(4): 440-46.
152. Egorov YS, Abalmasov KG, Ivanov VV et al. Autotransplantation of the greater omenlum in the treatment of chronic lymphedema. Lymphotogy 1994; 27(3): 137-43.
153. Kambayashi J, Ohshiro T, Mori T. Appraisal of myocutaneous flapping for treatment of postmastectomy lymphedema. Case report. Acta Chir Scand 1990; 156(2): 175-77.
154. Chitale VR. Role of tensor fascia lata musculocutaneous flap in lymphedema of the lower extremity and external genitalia. Ann Plast Surg 1989; 23(4): 297-304.
155. Mavili ME, Naldloken S, Safak T. Modified Charles operation for primary fibrosclerotic Iymphedema. Lympholagy 1994; 27(1): 14-20.
156. Kobayashi MR, Miller TA. Lymphedema. Clin Plast Surg 1987; 14(2): 303-13.
157. Sando WC, Nahai F. Suction lipectomy in the management of limb lymphedema. Clin Plast Surg 1989; 16(2): 369-73.
158. O'Brien BM, Khazanchi RK, Kumar PA, Dvir E, Pederson WC. Liposuction in treatment of lymphedema; a preliminary report. Br J Plast Surg 1989; 42(5): 530-33.