Related Experiment Video
Updated: Oct 17, 2025
A Revised Method for Inducing Secondary Lymphedema in the Hindlimb of Mice
Published on: November 2, 2019
Predictors of severity of lymphosclerosis in extremity lymphedema
1Division of Plastic and Reconstructive Surgery, National Taiwan University Hospital Yunlin Branch, Douliu City, Taiwan; Department of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.
Background:
Lymphovenous anastomosis (LVA) is an accepted method for treating lymphedema, and its efficacy could be greatly affected by the severity of lymphosclerosis. In the present study, we analyzed the intraoperative findings of lymphatic ducts in our patients who had undergone LVA to find predictive factors for the severity of lymphosclerosis.
Methods:
The medical records of the patients who had undergone LVA for managing extremity lymphedema from September 2017 to December 2020 were reviewed. The severity of lymphosclerosis was evaluated intraoperatively under a surgical microscope and stratified using the NECST (normal, ectasia, contraction, sclerosis type) classification. Patient age, gender, body mass index (BMI), lymphoscintigraphy stage, and lymphatic duct locations were included for analysis.
Results:
Multivariate linear regression analysis showed that location in a lower extremity (regression coefficient, -0.38; P = .03) and more advanced Taiwan lymphoscintigraphy stage (regression coefficient, 0.27; P < .001) were associated with more severe lymphosclerosis. In a subgroup analysis of lower extremity lymphedema, in addition to the Taiwan lymphoscintigraphy stage (regression coefficient, 0.24; P < .001), age (regression coefficient, 0.02; P = .001), and BMI (regression coefficient, 0.04; P = .005) were also associated with the severity of lymphosclerosis.
Conclusions:
The severity of lymphosclerosis in extremity lymphedema correlated positively with the Taiwan lymphoscintigraphy stage and was more severe in lower limb lymphedema. In lower limb lymphedema, a higher BMI and older age also contributed to more severe lymphosclerosis.
Related Concept Videos
01:27Assessment of the Cardiovascular System III: Palpation
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
01:15Development of the Lymphatic System
The first lymph sacs to form are the paired jugular lymph sacs located at the junction of the internal jugular and subclavian veins. From these sacs, lymphatic capillary plexuses extend to the thorax, upper limbs, neck, and head, eventually forming lymphatic vessels. Each jugular lymph sac maintains a...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation