Surgical treatment of genital manifestations of lymphatic filariasis: a systematic review

Lim, Kah Heng Alexander, Speare, Rick, Thomas, Gail, and Graves, Patricia (2015) Surgical treatment of genital manifestations of lymphatic filariasis: a systematic review. World Journal of Surgery, 39 (12). pp. 2885-2899.

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Abstract

Genital manifestations of lymphatic filariasis (genital LF) are a significant cause of disfigurement and disability in the developing world. Surgery is the standard treatment; however, definitive publications are lacking and best practice remains unclear. An exhaustive search strategy using keyword and subject headings was applied to Medline, EMBASE, Web of Science, CINAHL, and Scopus. Additionally citation lists, Google and Google Scholar, archives of relevant journals and websites were searched systematically. Studies with data on one or more human patient(s) who underwent surgery for genital LF were included. Articles were screened and data extracted by the first author with data verification by the second author. Fifty-seven studies were included: 18 series of ablative surgery, four series of non-ablative surgery and 35 case reports. Poor study quality, heterogeneous case definitions, lack of severity grading and limited follow-up precluded meta-analysis. Two series of simple hydrocelectomies performed in resource-limited settings reported early complication rates of 3.0–3.5 % using eversion and 5–7 % using excision, with recurrence of 7 % and 3–5 %, respectively. Complications were minimal for single-surgeon series and greater (12–18 %) when scrotal reconstruction was performed. There is little useful evidence for lymphatic bypass procedures in genital LF. Under-recognition of atypical manifestation of genital LF leads to potentially unnecessary surgeries. Surgery for genital LF is safe in resource-limited settings; however, more well-designed studies with better follow-up are needed. Research priorities include validation of case definitions and severity grading systems, and solutions to improve post-operative follow-up in resource-limited settings.

Item ID: 41504
Item Type: Article (Research - C1)
ISSN: 1432-2323
Date Deposited: 07 Dec 2015 04:11
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1108 Medical Microbiology > 110803 Medical Parasitology @ 33%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110323 Surgery @ 34%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111703 Care for Disabled @ 33%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 25%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920119 Urogenital System and Disorders @ 25%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920403 Disability and Functional Capacity @ 50%
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