Surgical treatment of lymphedema: State-of the-art

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Ooi, Adrian SH

Singapore General Hospital, Singapore

: J Regen Med

Abstract

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Lymphedema is a problem that has long vexed physicians. It affects about 200million people worldwide, and in the developed world commonly occurs after treatment for various cancers, with up to a 30% and 50% incidence in patients who receive axillary lymph node and groin lymph node dissection respectively. In the past, treatments were mainly conservative and excisional. The latter, though providing symptomatic relief, led to unsightly scars with high recurrence rates. Recent developments in the understanding of lymphedema pathophysiology and supramicrosurgical techniques has led to much improved physiological treatments for lymphedema. Imaging techniques such as lymphoscintigraphy, indocyanine green near infrared spectroscopy, and MR-Lymphangiograms have led to greater understanding and better classification of lymphatic flow. Surgical treatments such as lymphaticovenous bypass and vascularized lymph node transfers has led to long term sustainable outcomes. This presentation summarizes the current knowledge on lymphatic physiology as well as investigations and state of the art treatment for lymphedema, with clinical case presentations.

Biography

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Dr Adrian Ooi is a Consultant Plastic Surgeon at the Singapore General Hospital. He attended medical school in London and completed his plastic surgery training at the Singapore General Hospital. He undertook advanced fellowships in reconstructive and aesthetic surgery at the University of Chicago Medical Centre and the renowned Wellington Hospital, London, respectively. Dr Ooi focuses on managing complex reconstructive cases, and has a special interest in skin cancer management, reconstructive surgery of the head and neck and breast, as well as lymphedema surgery. He has published widely in various topics on plastic surgery, and is the author of numerous book chapters on reconstructive surgery. adrian.ooi.s.h@singhealth.com.sg