Lymphatic Disease

Prepared by Michael Ricci, MD

Corresponding chapter in Handbook of Venous Disorders: Chapters 57, 58, 59 and 60

• Browse NL. The diagnosis and management of primary lymphedema. J Vasc Surg 1986; 3:181-4.

PMID: 3510325

Comment: This article remains an excellent summary of the pathology, clinical features, diagnosis and treatment of lymphedema.

• Gloviczki P, Calcagno D, Schirger A, Pairolero PC, Cherry KJ, Hallett JW, Wahner HW. Non invasive evaluation of the swollen extremity: experiences with 190 lymphoscintigraphic examinations. J Vasc Surg 1989; 9:683-90.

PMID: 2724456

Comment: This classic paper described the utility, reliability, and also the limitations of lymphoscintigraphy in the diagnosis of
lymphedema. Importantly, it also provided a rationale for utilization of this test pre-operatively in planning operations for lymphedema.

• Gloviczki P, Fisher J, Hollier LH, Pairolero PC, Schirger A, Wahner HW. Microsurgical lymphovenous anastomosis for treatment of lymphedema: a critical review. J Vasc Surg 1988;7:647-52.

PMID: 3367429

Comment: The authors applied previous animal experimental work to patients and bravely report less than optimal results. Though it may be possible to perform this operation in carefully selected patients, caution is advised.