231 Breast Lymphedema After Breast Conservative Surgery; An Up-To-Date Systematic Review

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Abouelazayem ◽  
M Elkorety ◽  
S Monib
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Breast Surgery ◽  
Treatment Options ◽  
Conservative Surgery ◽  
Breast Size ◽  
Search Term ◽  
Common Complication ◽  
Breast Conservative Surgery ◽  
Conservative Breast Surgery

Abstract Background While arm lymphedema following breast cancer treatment is a common complication; breast lymphedema following treatment is not uncommon. Several risk factors were found to contribute to breast lymphedema, Aim: We aimed to provide a systematic review to help avoiding or management of breast lymphoedema Method The search term 'breast lymphedema' was combined with 'breast conservative surgery' and was used to conduct literature research in PubMed and Medline. The term lymphedema was combined with breast, conservative and surgery to search Embase database. All papers published in English were included with no exclusion date limits Results A total of 2155 female patients were included in this review; age ranged from 26 to 90. Mean BMI was 28.4, most of the studies included patients who underwent conservative breast surgery. Incidence of breast lymphedema ranged from 24.8% to 90.4%. Several risk factors were linked to breast lymphedema after conservative breast surgery, such as body mass index (BMI), breast size, tumour size, tumour site, type of surgery and adjuvant therapy. Treatment options focused on decongestive lymphatic therapy, including Manual lymphatic drainage (MLD), self-massaging, compression bras or Kinesio taping. Conclusions Breast lymphedema is a relatively common complication, yet there is no clear consensus on the definition or treatment options.

scholarly journals P28 Breast Lymphedema after breast conservative surgery; an up-to-date systematic review

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Mohamed Abouelazayem ◽  
Mohamed Elkorety ◽  
Sherif Monib ◽  
Mohamed Abouelazayem
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Systematic Review ◽  
Body Mass Index ◽  
Breast Surgery ◽  
Treatment Options ◽  
Conservative Surgery ◽  
Common Complication ◽  
Breast Conservative Surgery ◽  
Conservative Breast Surgery

Abstract Background While arm lymphedema following breast cancer treatment is a common complication; breast lymphedema following treatment is not uncommon. Several risk factors were found to contribute to breast lymphedema, including axillary surgery, high BMI, increased bra cup size, adjuvant chemotherapy, locoregional and radiotherapy boost and upper outer quadrant tumours. Aim We aimed to provide an up to date systematic review to help avoiding or managing breast lymphoedema after Breast conservative surgery for breast cancer. Methods The search term 'breast lymphedema' was combined with 'breast conservative surgery' and was used to conduct a literature research in PubMed and Medline. The term lymphedema was combined with breast, conservative and surgery to search Embase database. All papers published in English were included with no exclusion date limits Results A total of 2155 female patients were included in this review; age ranged from 26 to 90. Mean body mass index was 28.4, most of the studies included patients who underwent conservative breast surgery. Incidence of breast lymphedema ranged from 24.8% to 90.4%. Several risk factors were linked to breast lymphedema after conservative breast surgery, such as body mass index (BMI), breast size, tumour size, tumour site, type of surgery and adjuvant therapy. Treatment options focused on decongestive lymphatic therapy, including Manual lymphatic drainage (MLD), self-massaging, compression bras or Kinesio taping. Conclusion Breast lymphedema is a relatively common complication, yet there is no clear consensus on the definition or treatment options.

scholarly journals The ‘wave sign’ in hip arthroscopy: a systematic review of epidemiological factors, current diagnostic methods and treatment options

2020 ◽  
Author(s):  
Jason Derry Onggo ◽  
James Randolph Onggo ◽  
Mithun Nambiar ◽  
Andrew Duong ◽  
Olufemi R Ayeni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Protective Factor ◽  
Treatment Options ◽  
Arthroscopic Surgery ◽  
Classification Systems ◽  
Diagnostic Methods ◽  
Suture Repair ◽  
Significant Heterogeneity ◽  
Epidemiological Factors

ABSTRACT This study aims to present a systematic review and synthesized evidence on the epidemiological factors, diagnostic methods and treatment options available for this phenomenon. A multi-database search (OVID Medline, EMBASE and PubMed) was performed according to PRISMA guidelines on 18 June 2019. All studies of any study design discussing on the epidemiological factors, diagnostic methods, classification systems and treatment options of the wave sign were included. The Newcastle–Ottawa quality assessment tool was used to appraise articles. No quantitative analysis could be performed due to heterogeneous data reported; 11 studies with a total of 501 patients with the wave sign were included. Three studies examined risk factors for wave sign and concluded that cam lesions were most common. Other risk factors include alpha angle >65° (OR=4.00, 95% CI: 1.26–12.71, P=0.02), male gender (OR 2.24, 95% CI: 1.09–4.62, P=0.03) and older age (OR=1.04, 95% CI: 1.01–1.07, P=0.03). Increased acetabular coverage in setting of concurrent cam lesions may be a protective factor. Wave signs most commonly occur at the anterior, superior and anterosuperior acetabulum. In terms of staging accuracy, the Haddad classification had the highest coefficients in intraclass correlation (k=0.81, 95% CI: 0.23–0.95, P=0.011), inter-observer reliability (k=0.88, 95% CI: 0.72–0.97, P<0.001) and internal validity (k=0.89). One study investigated the utility of quantitative magnetic imaging for wave sign, concluding that significant heterogeneity in T1ρ and T2 values (P<0.05) of acetabular cartilage is indicative of acetabular debonding. Four studies reported treatment techniques, including bridging suture repair, reverse microfracture with bubble decompression and microfracture with fibrin adhesive glue, with the latter reporting statistically significant improvements in modified Harris hip scores at 6-months (MD=19.2, P<0.05), 12-months (MD=22.0, P<0.05) and 28-months (MD=17.5, P<0.001). No clinical studies were available for other treatment options. There is a scarcity of literature on the wave sign. Identifying at risk symptomatic patients is important to provide prompt diagnosis and treatment. Diagnostic techniques and operative options are still in early developmental stages. More research is needed to understand the natural history of wave sign lesions after arthroscopic surgery and whether intervention can improve long-term outcomes. Level IV, Systematic review of non-homogeneous studies.

scholarly journals Treatment of Post-Breast Surgery Pain Syndrome with Botulinum Toxin: Analysis of The Response to the Addition of Levobupivacaine and to the Type of Surgery

2021 ◽  
pp. 115-118
Author(s):  
Ana-Belén Puentes-Gutiérrez ◽  
María García-Bascones ◽  
Marcelino Sánchez-Casado ◽  
Laura Fernández-García ◽  
Rebeca Puentes-Gutiérrez ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Breast Surgery ◽  
Botulinum Toxin Type A ◽  
Pain Syndrome ◽  
Conservative Surgery ◽  
Botulinum Toxin Type ◽  
Pectoralis Major ◽  
Breast Conservative Surgery ◽  
Surgical Pain ◽  
Type Of Surgery

Background: The spasm and/or contracture of the pectoralis major contribute to the post-breast surgery pain. The purpose of our study was to evaluate changes in the post-breast surgical pain syndrome after the infiltration of botulinum-toxin type-A (BTX-A), according to the type of surgery and the reconstitution of the botulinum-toxin. Methods: This retrospective study was conducted at the Rehabilitation Department with two cohorts: BTX-A reconstituted with saline solution (SS group) or with levobupivacaine (LV group). Data about pectoralis major contracture and pain (global, at night, at rest and during activity) before the infiltration and six weeks after that were collected from the medical records and compared between SS and LV groups, and between conservative breast surgery and mastectomy cases. Results: in the study, 48 women aged 53.3 (±11.10) years were included, with 26 (54.2%) in SS group and 22 (45.8%) in LV group. There were no differences between both groups except transitory paresis (3.8% vs 22.7%; P=0.022). In all patients, baseline circumstances vs after 6 weeks were compared, and we found significant differences in contracture (1,77 (±0.57) vs 0.97 (±0.79)), VAS global (5.45 (±1.92) vs 3.46 (±2.48)), VAS night (3.17 (±3.13) vs 1.61 (±2.29)), VAS rest (2.14 (±2.56) vs 1.21 (±1.98)) and VAS activity (4.31 (±2.55) vs 2.78 (±2.58)). We found higher improvements in the breast conservative surgery. Conclusion: A significant lower pain and contracture after BTX-A injection in the pectoralis major was observed, but its reconstitution in levobupivacaine may not be an effective method to increase the analgesic effect. There were higher improvements in the breast conservative surgery than in the mastectomy.

Breast Lymphedema after breast conservative surgery; a systematic review

2021 ◽  
Vol 47 (1) ◽  
pp. e14
Author(s):  
Mohamed Abouelazayem ◽  
Mohamed Elkorety ◽  
Sherif Monib
Keyword(s):  
Systematic Review ◽  
Conservative Surgery ◽  
Breast Conservative Surgery

scholarly journals Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review

2019 ◽  
Vol 41 (08) ◽  
pp. 508-519 ◽  
Author(s):  
Júlia Ferreira Fante ◽  
Thais Daniel Silva ◽  
Elaine Cristine Lemes Mateus-Vasconcelos ◽  
Cristine Homsi Jorge Ferreira ◽  
Luiz Gustavo Oliveira Brito
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Urinary Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Data Extraction ◽  
Meta Analysis ◽  
Treatment Options ◽  
Cross Sectional ◽  
Adequate Knowledge

Objective We sought to investigate whether women present adequate knowledge of the main pelvic floor disorders (PFDs) (urinary incontinence – UI, fecal incontinence – FI, and pelvic organ prolapse – POP). Data sources A systematic review was performed in the MEDLINE, PEDro, CENTRAL, and Cochrane databases for publications from inception to April 2018. Selection of studies A total of 3,125 studies were reviewed. Meta-analysis was not possible due to the heterogeneity of primary outcomes and the diversity of instruments for measuring knowledge. The quality of the articles included in the analysis was evaluated with the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. Data collection Two authors performed data extraction into a standardized spreadsheet. Data synthesis Nineteen studies were included, comprising 11,512 women. About the methodological quality (NOS), most of the studies (n = 11) presented a total score of 6 out of 10. Validated questionnaires and designed pilot-tested forms were the most frequently used ways of assessing knowledge. Some studies were stratified by race, age, or group minorities. The most used questionnaire was the prolapse and incontinence knowledge questionnaire (PIKQ) (n = 5). Knowledge and/or awareness regarding PFD was low to moderate among the studies. Urinary incontinence was the most prevalent PFD investigated, and the most important risk factors associated with the lack of knowledge of the pelvic floor were: African-American ethnicity (n = 3), low educational level (n = 4), low access to information (n = 5) and socioeconomic status (n = 3). Conclusion Most women have a gap in the knowledge of pelvic floor muscle dysfunctions, do not understand their treatment options, and are not able to identify risk factors for these disorders.

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