발표 논문
| 이달의 논문 2026년 1월 | ||
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| 등록일 : 2026.04.13 | ||
Barcelona Consensus Paper on Reconstructive Lymphedema Surgery: A Delphi StudyAffiliations
AbstractBackground: Lymphedema-a chronic condition characterized by accumulation of lymph fluid due to malfunction of the lymphatic system-remains a significant clinical challenge despite advances in diagnosis and treatment. Given that lymphatic surgery is an important therapeutic option, the aim of the current study was to establish an expert consensus on recommendations for improving the surgical management of lymphedema. Methods: This international consensus study involved a modified nominal group and Delphi process. During the World Symposium for Lymphedema Surgery in 2023, the steering group invited 5 experts to participate in a nominal group with the aim of drawing up a set of 7 preliminary recommendations. These recommendations were then evaluated and revised by a panel of 31 international experts in a 2-round Delphi process. The threshold for consensus was set at a minimum of 70% agreement among panelists. Results: Consensus regarding the content of the 7 recommendations was high (mean overall agreement of 79.6%). Agreement was highest for the recommendations concerning specific reconstructive surgery techniques, measures for prevention and clinical assessment of lymphedema, and postintervention follow-up protocols. Conclusions: The consensus recommendations on the surgical management of lymphedema highlight the importance of preoperative preparation of patients and careful clinical assessment. Also recommended is the use of preventive surgical procedures, including the combination of reconstructive and reductive techniques, along with multidisciplinary monitoring and follow-up. These guidelines hold promise; further studies are required to evaluate their implementation and explore their impact on outcomes.
Preservation versus Structural Cranioplasty: A New Concept for Craniosynostosis TreatmentAffiliations
AbstractCraniosynostosis, a condition characterized by the premature closure of one or more cranial sutures, can be classified based on the affected suture, the number of sutures involved, or the presence of syndromic features. Although numerous surgical techniques have evolved to address cranial deformities, there remains a need for systematic categorization of these approaches. This review aims to explore current craniosynostosis treatments, evaluate their respective advantages and disadvantages, and propose a new classification distinguishing preservation cranioplasty from structural cranioplasty. The choice between preservation and structural cranioplasty is influenced by factors such as patient age, complexity of suture involvement, and resource availability. Preservation cranioplasty techniques, including suturectomy and distraction osteogenesis, prioritize maintaining cranial vault integrity and minimizing dural detachment, thus reducing surgical risks and facilitating natural cranial growth. Conversely, structural cranioplasty involves extensive bone displacement and dural exposure, offering effective correction for complex deformities and syndromic cases but with increased procedural risks. We propose categorizing craniosynostosis surgical treatments into two primary approaches: Preservation and structural cranioplasty. Preservation cranioplasty focuses on minimal invasion to support natural brain and skull development, while structural cranioplasty involves extensive remodeling necessary for severe or syndromic cases. Understanding these paradigms enables better-tailored treatment strategies and may improve long-term craniofacial outcomes. Keywords: bandeau; coronal; cranioplasty; craniosynostosis; distraction; fronto-orbital advancement; one-piece cranioplasty; preservation cranioplasty; structural cranioplasty. |
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