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Frequency: 3 issues
Online ISSN 1827-1766
Gasbarro V. 1, Cataldi A. 2
1 Unità Operativa di Chirurgia Vascolare, Dipartimento di Chirurgia, Anestesia e Radiologia, Arcispedale S. Anna, Università degli Studi di Ferrara, Ferrara;
2 Dipartimento di Chirurgia Generale e Vascolare, Ospedale del Delta, Lagosanto, Ferrara
A method to classificate lymphedema has been needed to gather important information on the clinical evolution of the disease using a common language and an easy clinical applicability. A proposal of a new classification of limb lymphedema is inspired to CEAP (classification, etiology, anatomy, physiopathology) for chronic venous insufficiency of the lower limb. The classification makes use of the acronym CEAP adding the letter L to underline the aspect “Lymphedema”. The classification has already been appraised in 2 years activity at the unit of vascular surgery of Ferrara and at the moment it is under close examination by a group of work involving many Italian scientific associa-tions. Clinical classification is based on the most objective sign in these patients, edema, which is classified in 5 classes. Etiologic aspect considers 2 types of alterations of the lymphatic system: congenital and acquired or secondary. Anatomic aspect has the object to specify the anatomic stuctures involved. Physiopatologi-cal moments are gathered in 5 groups: agenesia or hypoplasia (absence of lymphatic vessels or scarce presence), hyperplasia (greater representation of lymphatics): in this case a valvular reflux pathology is frequentely associated; obstruction (by parasites, tumors, after surgery operations and radiotherapy); reflux (primitive disease of valves); overload (equal to dynamic deficiency, according to Foldi). The proposal of a new classification of lymphedema CEAP-L will allow to arrange patients with a definite classification sign, thus creating the conditions for a better clinical comparison and the possibility to study these patients in well defined statistic groups and not in evolutive periods that include many aspects under a single class.