Conventionally, lower limb circumference is measured using a measuring tape; however, a measuring tape may not provide sufficient precision to measure the magnitude of the lymphedema. We report the use of three-dimensional photography (VECTRA®) for the evaluation of lymphedema in patients after lymphovenous anastomosis (LVA).
Methods:
We calculated the percent error in measuring lower limb circumference with a measuring tape. We performed VECTRA before and after LVA and measured the change in volume. Because of the limitation of photographic range, the measurement of the entire lower limb was difficult using this approach. We were limited to thigh measurements.
Results:
The ratio of error was calculated using the largest and smallest mean measurements. The largest measurement errors, 4.3%–5.8%, were observed for the measurement of thigh circumferences, whereas the smallest measurement errors, 2.3%–2.9%, were observed in the foot and lower leg areas. The change in volume postoperatively measured using VECTRA decreased by an average of 35.1 cc.
Conclusions:
The evaluation with a measuring tape for the foot and lower leg region was useful because a lesser content of soft tissue was not influenced to the error by power. Contrarily, VECTRA was useful for measuring the thigh region because of the higher quantity of soft tissue, and the combination of both reduced the error.
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References
1.
AkitaS, MitsukawaN, KuriyamaM, KubotaY, HasegawaM, TokumotoH, IshigakiT, TogawaT, KuyamaJ, SatohK. Comparison of vascularized supraclavicular lymph node transfer and lymphaticovenular anastomosis for advanced stage lower extremity lymphedema. Ann Plast Surg, 2015; 74:573–579.
2.
MiharaM, HaraH, NarushimaM, TodokoroT, IidaT, OhtsuH, MuraiN, KoshimaI. Indocyanine green lymphography is superior to lymphoscintigraphy in imaging diagnosis of secondary lymphedema of the lower limbs. J Vasc Surg Venous Lymphat Disord, 2013; 1:194–201.
3.
YamamotoT, MatsudaN, TodokoroT, YoshimatsuH, NarushimaM, MiharaM, UchidaG, KoshimaI. Lower extremity lymphedema index: A simple method for severity evaluation of lower extremity lymphedema. Ann Plast Surg, 2011; 67:637–640.
4.
YamamotoT, YamamotoN, HayashiN, HayashiA, KoshimaI. Practicality of the lower extremity lymphedema index: Lymphedema index versus volumetry-based evaluations for body-type-corrected lower extremity volume evaluation. Ann Plast Surg, 2016; 77:115–118.
5.
UgurS, ArıcıC, YaprakM, MescıA, ArıcıGA, DolayK, OzmenV.Risk factors of breast cancer-related lymphedema. Lymphat Res Biol, 2013; 11:72–75.
6.
TepperOM, UngerJG, SmallKH, FeldmanD, KumarN, ChoiM, KarpNS. Mammometrics: The standardization of aesthetic and reconstructive breast surgery. Plast Reconstr Surg, 2010; 125:393–400.
7.
Irvine DuncanD. Nonexcisional tissue tightening: Creating skin surface area reduction during abdominal liposuction by adding radiofrequency heating. Aesthet Surg J, 2013; 33:1154–1166.
8.
SasakiGH. Quantification of human abdominal tissue tightening and contraction after component treatments with 1064-nm/1320-nm laser-assisted lipolysis: Clinical implications. Aesthet Surg J, 2010; 30:239–245.
9.
SawyerAR, SeeM, NdukaC. Quantitative analysis of normal smile with 3D stereophotogrammetry—An aid to facial reanimation. J Plast Reconstr Aesthet Surg, 2010; 63:65–72.
10.
MenezesM, RosatiR, FerrarioVF, SforzaC. Accuracy and reproducibility of a 3-dimensional stereophotogrammetric imaging system. J Oral Maxillofac Surg, 2010; 68:2129–2135.
11.
JaconoAA, MaloneMH, TaleiB. Three-dimensional analysis of long-term midface volume change after vertical vector deep-plane rhytidectomy. Aesthet Surg J, 2015; 35:491–503.
12.
GatherwrightJR, BrownMS, KatiraKM, RoweDJ. Three-dimensional changes in the midface following malar calcium hydroxyapatite injection in a cadaver model. Aesthet Surg J, 2015; 35:169–175.
ArdehaliB, NouraeiSA, Van DamH, DexE, WoodS, NdukaC. Objective assessment of keloid scars with three-dimensional imaging: Quantifying response to intralesional steroid therapy. Plast Reconstr Surg, 2007; 119:556–561.
16.
HameetemanM, VerhulstAC, VreekenRD, MaalTJ, UlrichDJ. 3D stereophotogrammetry in upper-extremity lymphedema: An accurate diagnostic method. J Plast Reconstr Aesthet Surg, 2016; 69:241–247.
17.
OhbaY, TodoY, KobayashiN, KaneuchiM, WatariH, TakedaM, SudoS, KudoM, KatoH, SakuragiN. Risk factors for lower-limb lymphedema after surgery for cervical cancer. Int J Clin Oncol, 2011; 16:238–243.
18.
YamamotoT, NarushimaM, DoiK, OshimaA, OgataF, MiharaM, KoshimaI, MundingerGS. Characteristic indocyanine green lymphography findings in lower extremity lymphedema: The generation of a novel lymphedema severity staging system using dermal backflow patterns. Plast Reconstr Surg, 2011; 127:1979–1986.
19.
AkitaS, MitsukawaN, KazamaT, KuriyamaM, KubotaY, OmoriN, KoizumiT, KosakaK, UnoT, SatohK. Comparison of lymphoscintigraphy and indocyanine green lymphography for the diagnosis of extremity lymphoedema. J Plast Reconstr Aesthet Surg, 2013; 66:792–798.
OnodaS, YamadaK, MatsumotoK, KimataY. A detailed examination of the characteristics and treatment in a series of 33 idiopathic lymphedema patients. J Reconstr Microsurg, 2017; 33:19–25.
DamstraRJ, VoestenHG, van SchelvenWD, van der LeiB. Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature. Breast Cancer Res Treat, 2009; 113:199–206.
24.
ChangDW, SuamiH, SkorackiR. A prospective analysis of 100 consecutive lymphovenous bypass cases for treatment of extremity lymphedema. Plast Reconstr Surg, 2013; 132:1305–1314.
25.
GjorupC, ZerahnB, HendelHW. Assessment of volume measurement of breast cancer-related lymphedema by three methods: Circumference measurement, water displacement, and dual energy X-ray absorptiometry. Lymphat Res Biol, 2010; 8:111–119.
26.
DeltombeT, JamartJ, ReclouxS, LegrandC, VandenbroeckN, TheysS, HansonP. Reliability and limits of agreement of circumferential, water displacement, and optoelectronic volumetry in the measurement of upper limb lymphedema. Lymphology, 2007; 40:26–34.
27.
MayrovitzHN, SimsN, LitwinB, PfisterS. Foot volume estimates based on a geometric algorithm in comparison to water displacement. Lymphology, 2005; 38:20–27.
28.
HayesS, CornishB, NewmanB. Comparison of methods to diagnose lymphedema among breast cancer survivors: 6-month follow-up. Breast Cancer Res Treat, 2005; 89:221–226.
29.
RidnerSH, ShihYC, DoersamJK, RhotenBA, SchultzeBS, DietrichMS. A pilot randomized trial evaluating lymphedema self-measurement with bioelectrical impedance, self-care adherence, and health outcomes. Lymphat Les Biol, 2014; 12:258–266.
30.
StantonAW, NorthfieldJW, HolroydB, MortimerPS, LevickJR. Validation of an optoelectronic limb volumeter (Perometer). Lymphology, 1997; 30:77–97.
31.
TierneyS, AslamM, RennieK, GraceP. Infrared optoelectronic volumetry, the ideal way to measure limb volume. Eur J Vasc Endovasc Surg, 1996; 12:412–417.
32.
CzerniecSA, WardLC, LeeMJ, RefshaugeKM, BeithJ, KilbreathSL. Segmental measurement of breast cancer-related arm lymphoedema using perometry and bioimpedance. Support Care Cancer, 2011; 19:703–710.
33.
SunWY, XiongJ, ShulmanMJ. Substitution of asparagine for serine-406 of the immunoglobulin mu heavy chain alters glycosylation at asparagine-402. Biochem Biophys Res Commun, 1991; 179:1627–1634.
GreeneAK, MaclellanRA. Operative treatment of lymphedema using suction-assisted lipectomy. Ann Plast Surg, 2016; 77:337–340.
36.
BoyagesJ, KastaniasK, KoelmeyerLA. WinchCJ, LamTC, ShermanKA, MunnochDA, BrorsonH, NgoQD, Heydon-WhiteA, MagnussenJS, MackieH. Liposuction for advanced lymphedema: a multidisciplinary approach for complete reduction of arm and leg swelling. Ann Surg Oncol, 2015; 22Suppl 3:S1263–S1270.
37.
BrorsonH. Liposuction in lymphedema treatment. J Reconstr Microsurg, 2016; 32:56–65.
