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Primary lymphedema of childhood: Treatment results from a tertiary center
Ece Cinar1, Benil Nesli Ata2, Sibel Eyigor1
1Ege University School of Medicine, Department of Physical Medicine and Rehabilitation, Turkey.
Insights
Complex decongestive therapy (CDT) effectively reduces excess limb volume in pediatric lymphedema patients. This study supports CDT as a safe and beneficial treatment for childhood lymphedema, improving outcomes in young individuals.
Area of Science:
- Lymphedema Rehabilitation
- Pediatric Lymphatic Disorders
- Vascular Medicine
Background:
- Primary lymphedema is the most common lymphatic disorder in children, stemming from congenital or hereditary lymphatic system malformations.
- Childhood lymphedema can manifest at birth or develop during childhood and adolescence, impacting quality of life.
Purpose of the Study:
- To evaluate the efficacy of Complex Decongestive Therapy (CDT) in managing pediatric lymphedema.
- To assess the impact of CDT on limb volume reduction in children diagnosed with lymphedema.
Main Methods:
- Retrospective analysis of pediatric lymphedema patients (under 18) treated with CDT at a university hospital.
- Limb volumes calculated using geometric formulas (truncated cone) and expressed as Percent Excess Volume (PEV).
- Measurements taken pre-treatment and weekly during CDT to track changes.
Main Results:
- The study included 34 limbs from 24 pediatric patients, with a mean age of 10.1 years.
- A statistically significant reduction in Percent Excess Volume (PEV) was observed post-CDT treatment (p < 0.05).
- Complex Decongestive Therapy (CDT) demonstrated a significant decrease in lymphedema severity.
Conclusions:
- Pediatric lymphedema management remains a challenging area with limited research.
- Complex Decongestive Therapy (CDT) is a safe and effective treatment modality for pediatric lymphedema.
- Findings support the integration of CDT into standard care for childhood lymphedema rehabilitation.
Background:
Primary lymphedema is the most common form of lymphedema presenting in the pediatric age group. Childhood lymphedema is caused by hereditary or congenital malformations in the lymphatic system that can manifest at birth or during childhood or adolescence.
Objectives:
Complex decongestive therapy (CDT) is the cornerstone of conservative management of lymphedema in both adult and pediatric lymphedema patients, although pediatric treatment guidelines are still lacking. In this study we aimed to assess the effects of CDT on pediatric patients.
Methods:
Childhood lymphedema patients who presented to the lymphedema rehabilitation unit of our university hospital before the age of 18 and who were treated for lymphedema with CDT were included in the study. Data on patient demographics, disease characteristics, and treatment duration were recorded. Limb volumes were calculated from patient measurements using a spreadsheet software (Limb Volume Calculator) that utilized the geometric formula for volume of a truncated cone. Measurements were taken before treatment and also weekly after initiation of treatment. Percent excess volume (PEV) was used instead of absolute volume difference to define the severity of lymphedema.
Results:
A total of 34 limbs from 24 patients were included in the study. The mean age of the patients was 10.1 ± 4.9 years and 14 (58.3 %) were female. Most patients had one affected limb but 16 had bilateral lower-extremity lymphedema. The mean duration of treatment with CDT was 153.6 ± 155.8 days. Excess volume percentage change between pre-treatment PEV (602.8 ± 713.8) and post-treatment PEV (514.6 ± 699.1) was found to be statistically significant (p < 0.05).
Conclusion:
Pediatric lymphedema management is a difficult and less well studied area in lymphedema rehabilitation. Our data support the use of CDT, which is a safe and effective treatment method, for pediatric lymphedema patients.
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