Barcelona lymphedema algorithm for surgical treatment (BLAST)

Upper limb lymphedema after breast cancer treatment is a progressive and disabling condition that can significantly impair the quality of life of affected individuals. Consequently, managing breast cancer-related lymphedema (BCRL) is a major challenge for patients and healthcare professionals. In th...

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Detalles Bibliográficos
Autores: Rodríguez-Bauzà, Elena, Pons, Gemma|||0000-0001-8803-5432, Masià, Jaume|||0000-0003-0141-9586
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:305886
Acceso en línea:https://ddd.uab.cat/record/305886
https://dx.doi.org/urn:doi:10.21037/abs-22-10
Access Level:acceso abierto
Palabra clave:Breast cancer-related lymphedema (BCRL)
Lymphatic-venous anastomosis (LVA)
Functional vascularized lymphatic tissue transfer (FVLTT)
Liposuction
Targeted-lymphatic axillary repair (T-LAR)
Descripción
Sumario:Upper limb lymphedema after breast cancer treatment is a progressive and disabling condition that can significantly impair the quality of life of affected individuals. Consequently, managing breast cancer-related lymphedema (BCRL) is a major challenge for patients and healthcare professionals. In the last few decades, various techniques have been developed for the treatment of BCRL, but the surgical approach to this condition remains in a state of constant evolution. Currently, the three main pillars for the surgical treatment of BCRL are lymphatic-venous anastomosis (LVA), functional vascularized lymphatic tissue transfer (FVLTT), and liposuction. The choice of one or other of these techniques usually depends on the presence or absence of a functional lymphatic system of the upper limb and axilla, and the degree of hypertrophy of the subcutaneous adipose tissue. A combination of techniques may sometimes be employed, either in the same intervention or in stages. However, the most recent trend is to identify transected lymphatic channels during axillary lymph node dissection and to immediately restore lymphatic drainage through LVA at the axillary level to prevent the development of BCRL. This article provides an overview of the clinical diagnosis and staging of BCRL, the imaging techniques used to assess the lymphatic system, a brief description of surgical techniques, and an update of the Barcelona lymphedema algorithm for surgical treatment (BLAST).