2017整理Lymphedemas of the extremities .ppt.ppt

Lymphedema of the Extremities :refers to a part of the human body because the lymphatic system defect lymph circulation caused by blocked,reverse flow, lead to limb lymphedema body shallow softtissue fluid agglomeration, secondary fiber of connective tissue hyperplasia, fat hardening, fascia thickening and the whole limb coarsens pathological shape。 Surgical therapy: 1.resectional, 2.diverting, 3.reconstructive procedures. Introduction 1.The lymphatic network is often underestimated. It can be damaged, often to a great extent, without causing trouble. 2.The vessels are small, and the content is almost invisible. The system has the ability to repair itself to a remarkable extent. a lymphatic disorder occurs, secondary changes develop in the affected tissue, and the treatment becomes difficult. 3.interference with the lymphatic system should be restricted tothe necessary extent, especially in oncologic surgery. In other circumstances, the surgical technique should respect the main lymphatic pathways. Pathophysiology Lymphatic physiology can be described as the balance or imbalance between the lymphatic load and the lymphatic transport capacity in a defined region of the body, The lymphatic load describes the amount of fluid and material that has to be cleared by the lymphatic system. The lymphatic transport capacity describes the clearance of the lymph fluid(lymphatic vessels and lymph nodes.) Iatrogenic medical interactions such as lymph node resections, transections of major lymphatic channels, followed by scar formation due to radiation or infection, are a major source affecting the transport capacity. Secondary tissue changes, such as a supply of adipose tissue and fibrosis occur, especially in a long-persisting imbalance with a predominance of the lymphatic load, Modern surgical strategies focus on the pathophysiology, trying to improve or normalize the lymphatic transport capacity, and to reduce surplus adipose tissue,