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  1. Book ; Online ; E-Book: Multimodal management of upper and lower extremity lymphedema

    Schaverien, Mark V. / Dayan, Joseph H.

    2022  

    Author's details edited by Mark V. Schaverien and Joseph H. Dayan
    Keywords Tumors/Surgery ; Molecular biology
    Subject code 616.4206
    Language English
    Size 1 online resource (221 pages) :, illustrations
    Publisher Springer
    Publishing place Cham, Switzerland
    Document type Book ; Online ; E-Book
    Remark Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
    ISBN 3-030-93039-4 ; 9783030930387 ; 978-3-030-93039-4 ; 3030930386
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  2. Book: Multimodal Management of Upper and Lower Extremity Lymphedema

    Dayan, Joseph H. / Schaverien, Mark V.

    2022  

    Author's details Mark V. Schaverien, MBChB MSc(Hons) MEd MRCS MD PGCert(FLM) FRCS(Plast), is an Associate Professor of Plastic and Reconstructive Surgery at The University of Texas MD Anderson Cancer Center, a Lymphedema Comprehensive Center of Excellence, and is an expert in complex reconstruction and microsurgery, in particular for breast surgery and lymphedema surgery. He obtained Bachelor of Medicine and Bachelor of Surgery degrees from the University of Edinburgh Medical School then undertook his surgical training in the United Kingdom, during which he completed a research fellowship at the University of Texas Southwestern Medical Center in Dallas. During his training he undertook four clinical fellowships, including at MD Anderson Cancer Center in Houston, and he received fellowship of the Royal College of Surgeons of England. He received a Master of Science in Surgical Technology with Honors from Imperial College London, a Master of Education in Surgical Education with Merit fromImperial Coll
    Keywords lipectomy ; Microsurgery ; anti-fibrotic ; anti-inflammatory ; lymphangiogenic therapy ; lymphatic reconstruction ; Lymph Node ; lymphatic system ; lymphedema ; lymph node ; microsurgery
    Language English
    Size 240 p.
    Edition 1
    Publisher Springer International Publishing
    Document type Book
    Note PDA Manuell_15
    Format 215 x 285 x 18
    ISBN 9783030930387 ; 3030930386
    Database PDA

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  3. Article: GLP-1 receptor agonist as an effective treatment for breast cancer-related lymphedema: a case report.

    Crowley, Fionnuala / Brown, Stav / Gallagher, Emily J / Dayan, Joseph H

    Frontiers in oncology

    2024  Volume 14, Page(s) 1392375

    Abstract: Introduction: Lymphedema is a major public health issue for many women undergoing breast cancer treatment. Although weight loss has been reported to be beneficial in the treatment of lymphedema, no studies to date have examined the use of GLP-1RAs for ... ...

    Abstract Introduction: Lymphedema is a major public health issue for many women undergoing breast cancer treatment. Although weight loss has been reported to be beneficial in the treatment of lymphedema, no studies to date have examined the use of GLP-1RAs for the treatment of secondary lymphedema. This case report describes a patient who experienced significant resolution of her breast cancer-related lymphedema after initiation of a GLP-1RA for weight loss.
    Main symptoms and/or important clinical findings: Nine months postoperatively the patient developed arm swelling and disability. While on adjuvant chemo and hormonal therapy, her weight increased dramatically and peaked 4 years later. Corresponding to her weight gain was significant worsening of her symptoms.
    The main diagnoses therapeutic interventions and outcomes: Due to adjuvant cancer-related weight gain and inability to lose weight with diet and exercise, she was referred for evaluation and diagnosed with lymphedema. The patient started treatment with a Glucagon-like peptide 1 receptor agonist and lost 24% of her body weight over the next 13 months. The improvement in her lymphedema mirrored her weight loss. Her limb volume difference dropped from 10.3% down to 3.4% and she no longer required a compression garment. Her imaging demonstrated return of lymphatic pumping and she experienced a significant improvement in quality of life, assessed by a validated lymphedema-specific patient reported outcome (PROM). She remains on hormonal therapy, no longer needs compression and is back to regular exercise without impairment.
    Conclusions: GLP-1 RAs provide a potential medical option for many patients struggling with weight gain and lymphedema. We have observed by all objective measures a significant reduction in lymphedema and the elimination of compression in the case presented as a direct result of GLP-1 RA. This may also reduce a patient's BMI to the point where they become a good candidate for lymphovenous bypass or vascularized lymph node transplant when indicated.
    Language English
    Publishing date 2024-04-18
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2024.1392375
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  4. Article ; Online: Correction of Nipple-Areola Complex Malposition with Conversion from Subpectoral to Prepectoral Plane: Proof of Concept.

    Kokosis, George / Dayan, Joseph H

    Plastic and reconstructive surgery

    2020  Volume 146, Issue 2, Page(s) 237e–238e

    MeSH term(s) Breast Implantation/adverse effects ; Breast Implantation/instrumentation ; Breast Implantation/methods ; Breast Implants/adverse effects ; Breast Neoplasms/surgery ; Carcinoma, Intraductal, Noninfiltrating/surgery ; Female ; Humans ; Mastectomy, Subcutaneous/adverse effects ; Nipples/surgery ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Proof of Concept Study ; Reoperation/methods ; Treatment Outcome
    Language English
    Publishing date 2020-08-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/PRS.0000000000007015
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  5. Article ; Online: The Vicious Circle of Stasis, Inflammation, and Fibrosis in Lymphedema.

    Brown, Stav / Dayan, Joseph H / Kataru, Raghu P / Mehrara, Babak J

    Plastic and reconstructive surgery

    2022  Volume 151, Issue 2, Page(s) 330e–341e

    Abstract: Summary: Lymphedema is a progressive disease of the lymphatic system arising from impaired lymphatic drainage, accumulation of interstitial fluid, and fibroadipose deposition. Secondary lymphedema resulting from cancer treatment is the most common form ... ...

    Abstract Summary: Lymphedema is a progressive disease of the lymphatic system arising from impaired lymphatic drainage, accumulation of interstitial fluid, and fibroadipose deposition. Secondary lymphedema resulting from cancer treatment is the most common form of the disease in developed countries, affecting 15% to 40% of patients with breast cancer after lymph node dissection. Despite recent advances in microsurgery, outcomes remain variable and, in some cases, inadequate. Thus, development of novel treatment strategies is an important goal. Research over the past decade suggests that lymphatic injury initiates a chronic inflammatory response that regulates the pathophysiology of lymphedema. T-cell inflammation plays a key role in this response. In this review, the authors highlight the cellular and molecular mechanisms of lymphedema and discuss promising preclinical therapies.
    MeSH term(s) Humans ; Lymphedema/etiology ; Lymphatic System ; Lymphatic Vessels ; Fibrosis ; Inflammation/etiology
    Language English
    Publishing date 2022-11-15
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/PRS.0000000000009866
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  6. Article ; Online: Immediate Lymphatic Reconstruction and the Current Value Problem.

    Rochlin, Danielle H / Coriddi, Michelle R / Nelson, Jonas A / Dayan, Joseph H / Mehrara, Babak J

    Annals of surgery

    2023  Volume 277, Issue 6, Page(s) e1197–e1199

    MeSH term(s) Humans ; Plastic Surgery Procedures ; Mastectomy ; Mammaplasty
    Language English
    Publishing date 2023-02-03
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000005814
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  7. Article: Neurotized Diagonal Profunda Artery Perforator Flaps for Breast Reconstruction.

    Dayan, Joseph H / Allen, Robert J

    Plastic and reconstructive surgery. Global open

    2019  Volume 7, Issue 10, Page(s) e2463

    Abstract: Although the deep inferior epigastric artery perforator flap remains the gold standard for autologous breast reconstruction, many patients are not candidates for this surgery. A variety of thigh-based flaps have been used including the diagonal upper ... ...

    Abstract Although the deep inferior epigastric artery perforator flap remains the gold standard for autologous breast reconstruction, many patients are not candidates for this surgery. A variety of thigh-based flaps have been used including the diagonal upper gracilis (DUG) flap, vertical upper gracilis flap, profunda artery perforator (PAP) flap, and lateral thigh perforator flap. However, each of these techniques has a unique set of benefits and drawbacks in terms of wound healing, donor site morbidity, and potential for lymphedema. We describe the first report of a sensate diagonal PAP flap for breast reconstruction: combining the benefits of the DUG (wider skin paddle and reliable wound healing) with the benefits of the PAP (muscle-sparing technique and greater distance from the lymphatic collectors). This was the authors' sentinel case in a woman with paraplegia and chronic leg swelling. Preoperative imaging, markings, and technical details are presented along with postoperative results. In the appropriately selected patient, this flap offers several advantages: a 2-team approach to reconstruction, ample tissue for breast reconstruction, potential neurotization for breast sensibility, wound closure in resting skin tension lines, and avoidance of the lymphatic drainage to the lower extremity. The diagonal PAP flap provides a muscle-sparing alternative to the DUG flap while minimizing the risk of lymphedema. Future studies are needed to assess the donor site morbidity of this flap; however, this case proves the safety and reliability of the diagonal PAP flap in our breast reconstruction population.
    Language English
    Publishing date 2019-10-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2851682-5
    ISSN 2169-7574 ; 2169-7574
    ISSN (online) 2169-7574
    ISSN 2169-7574
    DOI 10.1097/GOX.0000000000002463
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  8. Article ; Online: An updated systematic review of esthetic grading tools in postmastectomy breast reconstruction.

    Stern, Carrie / Kim, Leslie N / Plotsker, Ethan / Boyce, Lindsay / Dayan, Joseph / Nelson, Jonas A

    Journal of surgical oncology

    2023  Volume 127, Issue 5, Page(s) 782–790

    Abstract: Background and objectives: We ascertained whether a validated esthetic grading tool for breast reconstruction had been developed and widely adopted since the last published systematic review on the topic from 2015.: Methods: We performed a systematic ...

    Abstract Background and objectives: We ascertained whether a validated esthetic grading tool for breast reconstruction had been developed and widely adopted since the last published systematic review on the topic from 2015.
    Methods: We performed a systematic review identifying all studies using a grading tool to assess breast reconstruction, using search terms associated with all types of breast surgery and outcomes research. Articles were assessed for patient number, validated scale use, assessor type and training, assessor blinding, assessment method, scoring system type, type and timing of reconstruction, and usage of corroborating scales.
    Results: Of 2809 articles screened, 148 met the criteria. Only 3 used a validated tool, the Esthetic Items Scale. Most used study-only tools (n = 111) or unvalidated tools (n = 28). The most used unvalidated tool was the Garbay/Lowery 5-subscale rubric. Unanchored Likert scales were the most common subjective tool; two-dimensional images were the most used medium. Surgeons, patients, and nurses were the most common assessors. Twenty percent of studies used corroborating scales.
    Conclusions: In the absence of a validated esthetic grading tool for breast reconstruction, researchers continue to rely on unvalidated scales. The only validated scale available is used infrequently and only validated among physicians. A validated, reliable, simple grading tool with clinical and scholastic relevance is needed.
    MeSH term(s) Humans ; Female ; Mastectomy ; Breast Neoplasms/surgery ; Mammaplasty/methods ; Outcome Assessment, Health Care ; Esthetics
    Language English
    Publishing date 2023-01-03
    Publishing country United States
    Document type Systematic Review ; Journal Article
    ZDB-ID 82063-5
    ISSN 1096-9098 ; 0022-4790
    ISSN (online) 1096-9098
    ISSN 0022-4790
    DOI 10.1002/jso.27186
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  9. Article ; Online: Nomenclature in Lymphedema Surgery.

    Coriddi, Michelle / Dayan, Joseph / Mehrara, Babak

    Plastic and reconstructive surgery

    2020  Volume 146, Issue 3, Page(s) 385e–386e

    MeSH term(s) Humans ; Lymphedema/surgery ; Terminology as Topic
    Language English
    Publishing date 2020-06-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/PRS.0000000000007098
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  10. Article ; Online: Accessory Lymphatic Drainage Pathways on Indocyanine Green Lymphography in Patients with Breast Cancer-Related Lymphedema.

    Kim, Leslie N / Mehrara, Babak / Dayan, Joseph / McGrath, Leslie / Coriddi, Michelle

    Plastic and reconstructive surgery

    2022  Volume 151, Issue 6, Page(s) 1015e–1021e

    Abstract: Background: Current predictive models of lymphedema risk cannot predict with 100% certainty which patients will go on to develop lymphedema and which will not. Patient-specific anatomic and physiologic differences may be the missing factor. The authors ... ...

    Abstract Background: Current predictive models of lymphedema risk cannot predict with 100% certainty which patients will go on to develop lymphedema and which will not. Patient-specific anatomic and physiologic differences may be the missing factor. The authors hypothesize that patients with accessory lymphatic pathways may have improved lymphatic drainage, resulting in smaller limb volumes.
    Methods: The authors reviewed indocyanine green (ICG) lymphography images of all patients who presented to their institution for evaluation of breast cancer-related lymphedema. Patients with unilateral upper extremity lymphedema, a full set of bilateral limb measurements, and ICG images of both limbs were included. Other variables of interest included patient demographics and length of follow-up. Patients with accessory pathways were determined independently, and conflicts were resolved with discussion. Abnormal images were also evaluated for common drainage pathways.
    Results: Thirty patients were identified as having accessory lymphatic drainage pathways. These patients had significantly smaller limb volume differences [8.19% (SD, 11.22)] compared with patients who did not exhibit these pathways [20.74% (SD, 19.76); P < 0.001]. The most common pathway was absence or rerouting of the radial bundle to the ulnar or volar bundles ( n = 16).
    Conclusions: The ability to create accessory lymphatic drainage pathways may be associated with improved lymphatic drainage, resulting in smaller limb volumes. Furthermore, certain drainage pathways appear to be more common than others. Description of these pathways should be considered for inclusion in ICG lymphography image grading criteria. Further study is needed to clarify the nature of these pathways and whether these pathways affect subjective symptoms and quality of life.
    Clinical question/level of evidence: Risk, II.
    MeSH term(s) Humans ; Female ; Indocyanine Green ; Lymphography/methods ; Breast Neoplasms/complications ; Breast Neoplasms/diagnostic imaging ; Quality of Life ; Breast Cancer Lymphedema/diagnostic imaging ; Breast Cancer Lymphedema/etiology ; Lymphedema/diagnostic imaging ; Lymphedema/etiology
    Chemical Substances Indocyanine Green (IX6J1063HV)
    Language English
    Publishing date 2022-12-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/PRS.0000000000010118
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