Table of contents
Lymphedema
What's new
Added 2022 AVF/AVLS/SVM, 2022 LNNI/PHA/HSE, and 2017 SIO guidelines for the evaluation and management of lymphedema.
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of lymphedema are prepared by our editorial team based on guidelines from the European Association of Urology (EAU/ASCO 2023), the European Society of Gynaecological Oncology (ESGO 2023), the American Vein and Lymphatic Society (AVLS/SVM/AVF 2022), the Public Health Agency of Northern Ireland (PHA/HSE/LNNI 2022), the Society for Integrative Oncology (SIO 2017),...
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Screening and diagnosis
Classification and risk stratification
Diagnostic investigations
Evaluation of limb swelling: as per AVF/AVLS/SVM 2022 guidelines, Obtain quantification of swelling in patients with lymphedema.
E
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Evaluation of head and neck swelling
Radionuclide lymphoscintigraphy
Genetic testing
Medical management
Nonpharmacologic interventions
Physical activity
As per HSE/LNNI/PHA 2022 guidelines:
Advise increasing physical activity levels gradually in patients at risk of lymphedema.
B
Encourage exercising with gradual, progressive resistance and aerobic exercise in at-risk patients.
A
Advise patients that they are not required to limit their physical activity or limit the use of their at-risk limb. B
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Compression therapy
Manual lymphatic drainage
Complex decongestive therapy
Surgical interventions
Indications for surgery: as per AVF/AVLS/SVM 2022 guidelines, Consider performing surgery after failing conservative treatment in patients with stage > 2 lymphedema.
E
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Liposuction
Lymphovenous anastomosis
Specific circumstances
Patients with breast cancer: as per SIO 2017 guidelines, Consider offering low-level laser therapy, manual lymphatic drainage, and compression bandaging to improve lymphedema in breast cancer survivors.
C
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Patients with head and neck cancer
Patients with vulvar cancer
Patients with penile cancer