Liposuction for XXXX : A Multidisciplinary Approach for Complete Reduction of Arm and Leg Swelling.

@entity1 @entity4269 @entity1442
PURPOSE: This research describes and evaluates a liposuction surgery and multidisciplinary rehabilitation approach for advanced @entity4269 of the upper and lower extremities. METHODS: A prospective clinical study was conducted at an @entity1442 Assessment Clinic (ALAC) comprised of specialists in plastic surgery, rehabilitation, imaging, oncology, and allied health, at Macquarie University, Australia. Between May 2012 and 31 May 2014, a total of 104 @entity1 attended the ALAC. Eligibility criteria for liposuction included (i) unilateral, non-pitting, International Society of Lymphology stage II/III @entity4269 ; (ii) limb volume difference greater than 25  %; and (iii) previously ineffective conservative therapies. Of 55 eligible @entity1 , 21 underwent liposuction (15  arm, 6  leg) and had at least 3  months postsurgical follow-up (85.7  % cancer-related @entity4269 ). Liposuction was performed under general anesthesia using a published technique, and compression garments were applied intraoperatively and advised to be worn continuously thereafter. Limb volume differences, bioimpedance spectroscopy (L-Dex), and symptom and functional measurements (using the @entity1 -Specific Functional Scale) were taken presurgery and 4  weeks postsurgery, and then at 3, 6, 9, and 12  months postsurgery. RESULTS: Mean presurgical limb volume difference was 45.1  % (arm 44.2  %; leg 47.3  %). This difference reduced to 3.8  % (arm 3.6  %; leg 4.3  %) by 6  months postsurgery, a mean percentage volume reduction of 89.6  % (arm 90.2  %; leg 88.2  %) [p  <  0.001]. All @entity1 had improved symptoms and function. Bioimpedance spectroscopy showed reduced but ongoing extracellular fluid, consistent with the underlying lymphatic pathology. CONCLUSIONS: Liposuction is a safe and effective option for carefully selected @entity1 with advanced @entity4269 . Assessment, treatment, and follow-up by a multidisciplinary team is essential.
