Annals of Phlebology

Table. 1.

The stages of lymphedema

ISL stage and description Campisi stage and description Recommended treatment
Subclinical 0 No swelling, change only on imaging
Mild I Accumulation of fluid which subsides with limb elevation, usually lasts <24 h, Pitting may occur Ia No overt swelling despite impaired lymph drainage LVA
Ib Reversible swelling with limb elevation
Moderate IIa Rarely resolves with limb elevation alone II Mild persistence of swellingwith elevation LVA, VLNT
IIb Loss of pitting to progression of dermal fibrosis III Persistent swelling with recurrent lymphangitis VLNT, liposuction
Severe III Lymphostatic elephantitiasis IV Fibrotic changes with column-like limb VLNT, liposuction, excision
No pitting, development trophic skin change V Elephantiasis with limb deformation incdluding lymphostatic warts

ISL: immediate lymphatic reconstruction, LVA: lymphaticovenular anastomosis, VLNT: vascularized lymph node transfer.

Ann Phlebology 2022;20:58~63
© Ann Phlebology