As described by Saaristo et al. in 2012, the surgical technique starts with wide axillary scar removal, followed by elevation of contralateral dual flap which includes DIEP/MS-TRAM with attached groin lymph nodes and fat, then the anastomosis is preferably done to internal mammary vessels.

Lymphedema

Lymphedema of Upper Arm

Mastectomy; Lymphedema

as the scope of study is breast cancer, participant should be of female gender

simultaneous free abdominal flaps with VLNT from groin are transferred on a single pedicle for breast reconstruction and postmastectomy lymphedema

Microvascular Breast Reconstruction with Vascularized Lymph Node Transfer

Microvascular Breast Reconstruction With Lymph Node Transfer

Evaluation of Outcomes of Microvascular Breast Reconstruction With Lymph Node Transfer for Postmastectomy Lymphedema Patients

Assessment of volume reduction by measuring limb circumference of affected and non affected upper limbs at fixed points from shoulder, elbow & wrist joints

lymphoscintigraphy will be used to trace radiological signs of Lymphatic flow improvement such as reduced dermal backflow, appearance of new lymph drainage channels, reduced stasis and increased rate of radiolabeled tracer clearance

Quality of life parameters will be measured using LYMQOL survey. Questions in the survey cover four areas: symptoms, body image/appearance, function and mood. Answers are scored 1-4 (less severe to severe)

patient quality of life will be evaluated using Breast-Q "Reconstruction Module", which includes different modules for assessment of quality of life and patient satisfaction after breast reconstruction. These scales are designed to be administered pre-operatively and assess patient expectations for the process and outcome of surgery. The expectations scales compliment the satisfaction and quality-of life domains of the postoperative reconstruction module. Multi-item and categorical scale structures are used. Five scales provide a 0-100 score. A higher score means better quality of life and more satisfaction.

Ahmed ElSayed Sharaf Ahmed

Assistant Lecturer

Assiut University

patients with postmastectomy lymphedema who will undergo ultrasonographic assessment of postmastectomy lymphedema and circumferential tape measurement of arm

Postmastectomy Lymphedema Syndrome

Qualitative assessment of postmastectomy lymphedema via ultrasound (Subcutaneous echogenicity (SEG) and subcutaneous echo-free space (SEFS) grade systems for postmastectomy lymphedema) and circumferential tape measures ( The circumferential measurement of affected arm at MCP joint, wrist joint, 15 below elbow joint, elbow joint 15cm above elbow point) to assess upper extremity volume

Ultrasonographic assessment of postmastectomy lymphedema

Marmara University School of Medicine Department of Physical Medicine and Rehabilitation

Reliability of Subcutaneous Echogenicity (SEG) Grade and Subcutaneous Echo-free Space (SEFS) Grade

The Inter- and Intra-rater Reliability of Subcutaneous Echogenicity (SEG) Grade and Subcutaneous Echo-free Space (SEFS) Grade in Postmastectomy Lymphedema

stage of the clinical severity of lymphedema

The circumferential measurement of affected arm at the metacarpophalangeal joints (MCP)

The circumferential measurement of affected arm at the MCP joints

The circumferential measurement of affected arm at wrist joint

The circumferential measurement of affected arm at 15 cm below the elbow joint point

The circumferential measurement of affected arm at the elbow joint point

The circumferential measurement of unaffected arm at the elbow joint point

The circumferential measurement of affected arm at 15 cm above the elbow joint point

Lymphedema of the limbs were assessed by a single physiotherapist using the circumferential and volumetric methods before and after the treatment protocol. The circumferential upper limb measurements were carried out with the arm abducted at 30°, starting at the level of the carpometacarpal joint, every 5 cm proximal to this point along both limbs. Then, a computer program (limb volumes professional version 5.0) was used to convert these values into limb volumes in milliliters.

Grade 0: No increase in echogenicity in the subcutaneous layer. Namely, the subcutaneous fat layer is observed as black. Grade 1: Diffuse increase in echogenicity, but identifiable horizontal or obliquely oriented echogenic lines caused by connective tissue bundles. Grade 2: Diffuse increase in echogenicity. Echogenic lines are not identifiable

Grade 0: No SEFS. Grade 1: Horizontally oriented (<45 degrees to the skin) SEFS only. Grade 2: Presence of vertically oriented (≥45 degrees to the skin) SEFS bridging the horizontally oriented SEFSs.

Marmara University

IB-IIA Cervical Cancer Patients with positive lymph node metastasis confirmed by intraoperative frozen pathological examination who will undergo radical hysterectomy and systematic pelvic lymphadenectomy

IB-IIA Cervical Cancer Patients with positive lymph node metastasis confirmed by intraoperative frozen pathological examination who will undergo radical hysterectomy and selective enlarged lymph node dissection.

Cervical Cancer

Radical hysterectomy and selective enlarged lymph node dissection

Lymph nodes debulking surgery.

Fudan university

Selective Pelvic Lymphadenectomy for IB-IIA Cervical Cancer

Study on Selective Pelvic Lymphadenectomy for IB-IIA Cervical Cancer

The period(months) from randomization to death for any cause (for patients who have been loss to follow-up prior to death, the last follow-up time is calculated as the time of death).

The period(months) from randomization to the earliest date of the date of tumor progression or the date of death for any cause. If the above standards are not met, the final evaluation date should be used for analysis.

Lymphedema Staging standards (Stage 0-3) according to the"consensus document"of the International Society of Lymphology.

Xiaohua Wu MD

Professor

Fudan University

2 weeks of intensive decongestive physiotherapy

Obstructive Sleep Apnea Syndrome

Intensive decongestive physiotherapy

CHUGA

Prevalence of Obstructive Sleep Apnea (OSA) in Patients With Lymphedema, Admitted for Intensive Decongestive Physiotherapy

Prevalence of Obstructive Sleep Apnea Syndrom in Patients With Lymphedema, Admitted for Intensive Decongestive Physiotherapy

Apnea/hypopnea index (AHI /h) measured by Apnea-Link or antecedent of Obstructive sleep apnea syndrom already treated with CPAP (Continuous Positive Airway Pressure) ventilation

Apnea/hypopnea index (AHI / h) before and after intensive decongestive physiotherapy.

Clinical signs associated with sleep apnea: snoring, feeling of suffocation or oppression during sleep, non-restorative sleep, daytime fatigue, concentration difficulties, nocturia (clinical questionnaire)

Measurement of limb perimeters (volumetry) before and after rehabilitation

Score of the Epworth sleepiness scale before and after rehabilitation

Score in the MOS-SF-36 questionnaire before and after rehabilitation

BMI (kg/m^2)before and after rehabilitation

Neck circumference (cm) before and after rehabilitation

elephantiasis/edema

Microvascular Breast Reconstruction With Lymph Node Transfer

Reliability of Subcutaneous Echogenicity (SEG) Grade and Subcutaneous Echo-free Space (SEFS) Grade

Selective Pelvic Lymphadenectomy for IB-IIA Cervical Cancer

Prevalence of Obstructive Sleep Apnea (OSA) in Patients With Lymphedema, Admitted for Intensive Decongestive Physiotherapy

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