Cheng Lymphedema Grading System

Say Goodbye to Compression Garments after Dr. Cheng’s Lymphedema Microsurgery

Lymphedema Grading Systems

Lymphedema Surgery - ExpertConsult.com

Using physical exam findings, history of disease and imaging modalities, several classification schemes have been proposed to stage lymphedema.

Perhaps the most widely used is the International Society of Lymphology staging system. But this staging system is based only the clinical symptoms, but no objective measurement or imaging assessment. As our understanding of lymphedema has evolved and technologies improved, other staging systems based on clinical presentation, circumferential measurements, objective measurements, lymphatic imaging or a combination thereof have been proposed.

At our center, we use the Cheng Lymphedema Grading system based on symptom severity, circumferential difference, and lymphoscintigraphy imaging to determine appropriate treatment, which was published on the Annals of Surgical Oncology, a renowned journal: A Prospective Evaluation of Lymphedema-Specific Quality-of-Life Outcomes Following Vascularized Lymph Node Transfer. (Patel KM, Lin CY, Cheng MH.) and book: Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. ISBN: 978-0-323-29897-1. July 2015.

Cheng Lymphedema Grading (table)

 

Lymphedema Grading Systems - Before Treatment photos - patients hands

Data source: Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. ISBN: 978-0-323-29897-1. July 2015, page 204.

 

Lymphedema Grading Systems - Before Treatment photos - patients legs

Data source: Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. ISBN: 978-0-323-29897-1. July 2015, page 204.

 

Taiwan Lymphoscintigraphy Staging

Lymphedema Grading Systems - Before Treatment photos and table - patients hands

Data source: Cheng MH, Pappalardo M, Lin C, Kuo CF, Lin CY, Chung KC. Validity of the Novel Taiwan Lymphoscintigraphy Staging and Correlation of Cheng LymphedemaGrading for Unilateral Extremity Lymphedema. Ann Surg. 2018 Sep;268(3):513-525

 

Lymphedema Grading Systems - Before Treatment photos and table - patients legs

Data source: Cheng MH, Pappalardo M, Lin C, Kuo CF, Lin CY, Chung KC. Validity of the Novel Taiwan Lymphoscintigraphy Staging and Correlation of Cheng LymphedemaGrading for Unilateral Extremity Lymphedema. Ann Surg. 2018 Sep;268(3):513-525

 

Partial obstruction

Lymphedema Grading Systems - Before and After Treatment photos

 

Total obstruction

Lymphedema Grading Systems - Before and After Treatment photos schema

 

Novel Taiwan Lymphoscintigraphy Staging System

Dr. Cheng is the author of the Cheng Lymphedema Grading System with integration of Taiwan Lymphoscintigraphy Staging which was published in Annals of Surgery (the top Surgery Journal) in July 2018. The Cheng Lymphedema Grading System with integration of Taiwan Lymphoscintigraphy Staging, a comprehensive objective assessment tool that analyzes lymphedema symptoms with quantitative measurements and advanced imaging technology, can effectively help physicians evaluate the severity of lymphatic obstructions, determine the accurate diagnosis, select the most appropriate procedures to treat lymphedema, and ultimately ensure the favorable functional outcome and finest quality of life for lymphedema patients.

 

Recommended reading journal:

  1. A Prospective Evaluation of Lymphedema-Specific Quality-of-Life Outcomes Following Vascularized Lymph Node Transfer.
    Patel KM, Lin CY, Cheng MH.
    Ann Surg Oncol. 2015 Jul;22(7):2424-30
    https://www.ncbi.nlm.nih.gov/pubmed/25515196
  2. Validity of the Novel Taiwan Lymphoscintigraphy Staging and Correlation of Cheng LymphedemaGrading for Unilateral Extremity Lymphedema.
    Cheng MH, Pappalardo M, Lin C, Kuo CF, Lin CY, Chung KC.
    Ann Surg. 2018 Sep;268(3):513-525.
    https://www.ncbi.nlm.nih.gov/pubmed/30004927
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