{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T10:25:45Z","timestamp":1778840745023,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lymphatic Research and Biology"],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Lymphedema of limbs is caused by partial or total obstruction of lymphatic collectors. In advanced cases all main lymphatics are obstructed and tissue fluid accumulates in the interstitial spaces. The microsurgical lympho-venous shunts cannot be performed. We propose in such cases drainage of fluid accumulations by creating artificial flow pathways to the nonobstructed regions by implantation of silicone tubes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To present the 3 to over 6 year follow-up results of therapy by subcutaneous implantation of silicone tubes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In 150 patients with obstructive limb lymphedema after pelvic or axillary lymphadenectomy and irradiation in uterine or breast cancer or following soft tissue inflammation silicone tubes were implanted subcutaneously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There was (1) immediate decrease of limb circumference within days after implantation; (2) in lower limbs in a 3-year follow-up a decrease in mid-calf circumference by a mean \u22128.7% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05) with range of \u22123.2% to \u221231.0% corresponding to 90\u2013900\u2009mL volume and in the mid-thigh a mean \u22121.8% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05) with range of \u22129.3% to +3% equal to 0\u2013900\u2009mL. In the upper limb in the 2-year follow-up the decrease in the mid-forearm was \u22128.5% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01) with a range of \u22123.0% to \u221222.0% and in the mid-arm a mean \u221212% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05) with a range of \u22127% to \u221222%. That corresponded to 180\u2013700\u2009mL volume for the limb; (3) decreased tissue stiffness; (4) maintenance of tubes patency on control lymphoscintigraphy, contrast opacification, and ultrasonography; and (5) lack of reaction to foreign body and effective control of inflammation at the site of implantation using low doses of benzathine penicillin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The technical simplicity of the surgical procedure, fast decrease of limb edema, and lack of tissue reaction to the implant make the method worth applying in advanced stages of lymphedema.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2018.0042","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T10:26:05Z","timestamp":1551263165000},"page":"557-564","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Edema Fluid Can Be Successfully Evacuated from the Lymphedematous Limbs by Implantation of Silicone Tubings Bypassing the Site of Flow Obstruction Long-Term Observations"],"prefix":"10.1177","volume":"17","author":[{"given":"Waldemar L.","family":"Olszewski","sequence":"first","affiliation":[{"name":"Central Clinical Hospital, Ministry of Home Affairs, Warsaw, Poland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marzanna T.","family":"Zaleska","sequence":"additional","affiliation":[{"name":"Department of Applied Physiology, Mossakowski Medical Research Center, Polish Academy of Sciences, Warsaw, Poland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajesh","family":"Hydrabadi","sequence":"additional","affiliation":[{"name":"Cardiovascular Clinic, Ahmedabad, India."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohal","family":"Banker","sequence":"additional","affiliation":[{"name":"Cardiovascular Clinic, Ahmedabad, India."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pallavi","family":"Kurulkar","sequence":"additional","affiliation":[{"name":"Cardiovascular Clinic, Ahmedabad, India."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,10,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1413.014"},{"key":"e_1_3_2_3_2","first-page":"347","article-title":"Clinical picture of lymphedema. 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