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8 - Il l<strong>in</strong>fedema<br />

BIBLIOGRAFIA:<br />

1. Ko DSC, Lerner R, Klose G, Cosimi AB. Effective treatment of Lymphedema of the extremities.<br />

Arch Surg, april 1998; vol. 133: 452-458.<br />

2. Yamamoto R, Yamamoto T. Effectiveness of the treatment-phase of two-phase complex<br />

decongestive physiotherapy for the treatment of extremity lymphedema. Int J Cl<strong>in</strong> Oncol,<br />

2007 dec;12(6): 463-8. Epub 2007 dec.<br />

3. Yamamoto T, Todo Y, Kaneuchi M, Handa Y, Watanabe K., Yamamoto R. Study of edema<br />

reduction patterns dur<strong>in</strong>g the treatment phase of complex decongestive physiotherapy for<br />

extremity l<strong>in</strong>mphedema. Lymphology, 2008 Jun,; 41(2): 80-6.<br />

4. L<strong>in</strong>ee guida diagnostico-terapeutiche delle malattie delle vene e dei l<strong>in</strong>fatici. Acta Phleb –<br />

Rev 2003 - Vol 4 n° 1-2 – Aug 2003, M<strong>in</strong>erva Medica.<br />

184<br />

ABSTRACT:<br />

8.3 - IL LINFEDEMA: Le possibilità della Chirurgia<br />

8.3 - IL LINFEDEMA:<br />

Le possibilità della Chirurgia<br />

Eretta C., Benatti E., , Berti S., Cevasco L.,<br />

Falco E., Maritato P., Rota A., Maritato F.<br />

Lymphedema is a pathologic condition where the lymphatic flow is obstucted<br />

or proceeds very slowly: the result is a progressive swell<strong>in</strong>g of the limbs.<br />

A typical complication is recurrent acute lymphangitis (erysipelas), that is<br />

responsable for a worsen<strong>in</strong>g of the cl<strong>in</strong>ical picture (swell<strong>in</strong>g and hardnes of the<br />

limb).<br />

This will let the lymphedema progress very fast, br<strong>in</strong>g<strong>in</strong>g the patient to<br />

<strong>in</strong>validat<strong>in</strong>g conditions and (rarely) to tumoral degeneration (Stewart-Treves<br />

syndrome).<br />

The cont<strong>in</strong>uous use of conservative treatment (bandag<strong>in</strong>g, physiotherapy and<br />

compressive stock<strong>in</strong>gs) br<strong>in</strong>gs for sure an improvement of the lymphedema.<br />

In selected cases, microsurgery of the lymphatics leads to an improvement, if it<br />

is associated with conservative therapy.<br />

INTRODUZIONE:<br />

Il l<strong>in</strong>fedema rappresenta un quadro patologico di non raro riscontro cl<strong>in</strong>ico<br />

caratterizzato dal rallentamento o dal blocco della circolazione l<strong>in</strong>fatica<br />

dell’arto o degli arti colpiti, con evoluzione progressivamente <strong>in</strong>gravescente<br />

e comparsa di ricorrenti complicanze di tipo l<strong>in</strong>fangitico acuto di natura per<br />

lo più erisipeloide, responsabili di un ulteriore e rapido aumento <strong>in</strong> volume e<br />

consistenza dell’edema. Viene così ad <strong>in</strong>staurarsi una sorta di circolo vizioso<br />

che, automantenendosi, determ<strong>in</strong>a la comparsa di un quadro cronico <strong>in</strong>fettivotossico-metabolico,<br />

con grave <strong>in</strong>validità del paziente e possibile, seppur<br />

fortunatamente rara, degenerazione sarcomatosa dei tessuti l<strong>in</strong>fedematosi (s. di<br />

185

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