{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T03:06:29Z","timestamp":1780110389307,"version":"3.54.0"},"reference-count":28,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"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":[[2022,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Lymphedema (LE) is a chronic condition of swelling due to lymphatic impairment and is characterized by edema and fibro-adipose tissue deposition. LE may be caused by an anomalous development of the lymphatic system, known as primary LE, or may develop secondary to traumatic, infectious, or other external events. Knowledge is increasing about the plural and bidirectional relationship between LE and obesity. The rate of obesity is increasing worldwide, and bariatric surgery offers the most effective and durable treatment, as this surgery exhibits positive effects on many obesity-related diseases. We explored whether bariatric surgery could improve leg volumes in morbidly obese LE patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      Between 2013 and 2019, 829 patients were hospitalized in our Center of Expertise for Lymphovascular Medicine for intensive treatment of their LE. Nine patients with end-stage primary, secondary, or obesity-induced LE underwent a bariatric procedure related to their morbid obesity. Data concerning age, gender, medical diagnosis, LE stage, type of bariatric treatment, body weight, body mass index (BMI), and limb volumes were retrospectively collected from the patient files. At the individual patient level, body weight, BMI, leg volumes, and their percent reduction between presurgery and postsurgery were calculated. At the group level, paired sample\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests were conducted to compare the mean body weight, BMI, and volumes of both legs between postsurgery and presurgery. The data demonstrate a significant decrease in body weight, BMI, and leg volumes in morbidly obese end-stage primary, secondary, and obesity-induced LE patients following bariatric surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our multiple case study indicates that bariatric surgery provides a good indication for concomitant treatment of morbid obesity and LE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2020.0055","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T19:32:58Z","timestamp":1617046378000},"page":"64-70","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Improvement of Limb Volumes After Bariatric Surgery in Nine End-Stage Primary, Secondary, and Obesity-Induced Lymphedema Patients: A Multiple Case Report"],"prefix":"10.1177","volume":"20","author":[{"given":"Ad A.","family":"Hendrickx","sequence":"first","affiliation":[{"name":"Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Drachten, The Netherlands."},{"name":"Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands."},{"name":"Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Damstra","sequence":"additional","affiliation":[{"name":"Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Drachten, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim P.","family":"Krijnen","sequence":"additional","affiliation":[{"name":"Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cees P.","family":"van der Schans","sequence":"additional","affiliation":[{"name":"Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands."},{"name":"Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands."},{"name":"Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,2,28]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000268"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-060116-022900"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.trsl.2019.04.001"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2017.0042"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2014.06.004"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1413.014"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60460-8"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30175-1"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70076-7"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-013-2715-7"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2016.04.011"},{"key":"e_1_3_3_13_2","first-page":"991","article-title":"Risk factors and prediction model for persistent breast-cancer-related lymphedema: A 5-year cohort study","volume":"27","author":"Penn IW","year":"2019","unstructured":"Penn IW, , Chang YC, , Chuang E, , Chen CM, , Chung CF, , Kuo CY, et al. Risk factors and prediction model for persistent breast-cancer-related lymphedema: A 5-year cohort study. 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Influence of complex descongestive physical therapy associated with intake of medium-chain triglycerides for treating upper-limb lymphedema. Rev Bras Fisioter, 2008; 12:31\u201336.","journal-title":"Rev Bras Fisioter"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2018.06.003"},{"key":"e_1_3_3_23_2","first-page":"1124","article-title":"Bariatric treatmet; A novel way to treat obese patients with lymphoedema. Abstracts from the 16th Congress of the International Federation of the Surgery of Obeity (2011)","volume":"21","author":"Ratnasingham K","year":"2011","unstructured":"Ratnasingham K, , Irukulla S, , Mansour S, , Din N, , Vasilikostas G, , Reddy M, , Wan A. Bariatric treatmet; A novel way to treat obese patients with lymphoedema. Abstracts from the 16th Congress of the International Federation of the Surgery of Obeity (2011). Obes Surg, 2011; 21:1124.","journal-title":"Obes Surg"},{"key":"e_1_3_3_24_2","first-page":"1202","article-title":"Intra-gastric balloon as a treatment for obesity related lymphoedema, a prospective cohort comparison study. Abstracts from the 5th Congress of the International Federation for the Surgery of Obesity and Metabolic Disorders European Chapter (IFSO-EC), Barcelona","volume":"22","author":"Khan O","year":"2012","unstructured":"Khan O, , Graham K, , Ahmed A, , Irukulla S, , Reddy M, , Vasilikostas G, , Wan A. Intra-gastric balloon as a treatment for obesity related lymphoedema, a prospective cohort comparison study. Abstracts from the 5th Congress of the International Federation for the Surgery of Obesity and Metabolic Disorders European Chapter (IFSO-EC), Barcelona. 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