Report IX National Congress ITALF
Lecce June 19, 20 and 21, 2025
Venue: Hotel Leone Messapia
‘From the splendid atmosphere of Lecce Baroque, the latest news on Lymphology and Lipedema’
Strong participation once again characterized the proceedings of the IX National ITALF Congress, held in the wonderful atmosphere of Salento, which is increasingly welcoming and inclusive, and of which Lecce is perhaps the brightest jewel.
As is tradition, the work began with a Meeting dedicated to patient associations, where all the main issues that daily affect patients and the healthcare professionals who care for them were discussed. LIO, Limphido, Resilia, and Linfo-TEAM (recently established on the initiative of a group of patients who sought treatment at Villa Regina) were present. As on other occasions, the Hon. De Lorenzo, President of FAVO, participated in the meeting. Regarding one of the topics discussed (that relating to cancer patients cured of the disease but who remain with disability induced by it, such as secondary lymphedema, without further protection regarding participation in healthcare costs for both diagnostic and therapeutic investigations), he announced that he will work with ITALF to create a bill, to be included in the next ‘Finance Law’, to remedy this care anomaly.
The Congress then began with a Lecture by Ezio Fulcheri, who described some of the mechanisms leading to the aging of the lymphatic system, a topic very rarely covered in international literature, yet important for better understanding the mechanisms that lead to certain pathological conditions. This was followed by Bellini with a description of the management of neonatal lymphatic malformations, a collaborator of Dr. Bertelli who described the pathways leading to genetic investigation of primary forms of lymphedema, and the geneticist Accadia who described syndromic conditions (both topics were thoroughly explored with explanatory questions asked by the undersigned during the discussion). Macciò then described the microscopic cellular and tissue anomalies that lead to macroscopically evident clinical pictures, and Cinti reported the still preliminary results of an ongoing experimental study aimed at better understanding the nature of the pathological tissue in Lipedema, which is inflamed and abnormal compared to healthy tissue and that of obese individuals. Hiro Suami then presented his theory on the Lymphosome, the anatomical district that affects a specific tissue area with common lymphatic structures.
Then it was Alfredo Leone’s turn, who presented the upcoming ‘Lymphedema Village’ patient ‘Campus’ which, also sponsored by ITALF this year, will be held in Viggianello (in Pollino) from July 20 to 26.
A well-attended Round Table followed, with interventions also from the floor, on the news regarding the new Tariff Nomenclature, concerning the inclusion of elastic garments (with their consequent eligibility for provision).
The second day opened with a session titled ‘Surgery and Surroundings’ where Mander, Gentileschi, Bruno, Gabriele, Boccardo, and Cestari explained the various indications for both individual surgical techniques and pre-operative and post-operative care phases.
A Lecture by Mestre-Godin followed on the effects of Sirolimus in lymphatic malformations, which can also be administered to adults.
Then it was the turn of new therapeutic proposals with Stasi on possible new criteria for classification and staging of lymphedema, Bellisi with new therapeutic experiences with mononuclear cells, Belgrado on the indications provided by videofluoroscopy, Bartoletti on the indications of physical therapy in oncological lymphedema, Fiengo on the physical treatment of Lipedema, and Leone on the pathophysiology of venous and lymphatic stasis.
The undersigned then presented the upcoming World Congress on Lipedema, which will be held in Rome on November 5, 6, 7, and 8.
Lectures by Moffat and Santoliquido followed. Christine Moffat, always present at the ITALF National Congress, presented her experience in trying to make the voice of sufferers heard even from the poorest regions of the world, and Santoliquido presented the importance of a healthy endothelium for the physiological functioning of vascular structures, particularly veins.
A round table then took place, led by the undersigned, on the etiological approach to peripheral edema. Galeandro, Genovese, Marini, Monferoce, Ricci, Rusca, and Santoliquido highlighted some diagnostic pathways with inevitable consequences on therapeutic procedures in the most common circumstances of peripheral edemas: deep vein thrombosis, lymphatic edema, post-traumatic edema, cardiac edema, drug-induced edema.
A Lecture by Spanish colleague Isabel Forner Cordero followed, on the analysis of various consensus documents on Lipedema.
Following this, an interesting round table on the network of rare diseases with particular regard to Lymphedema was held, with the participation of the General Director of the ASL of Lecce, Rossi, the President of the Order of Physicians of the province of Lecce, De Maria, Dr. Sciuscio, the General Director of the Perrino Hospital, Sister Bramato, the Regional Coordinator of Rare Diseases in Puglia, Annichiarico, the ITALF lawyer Santangelo, Dr. Monferoce representing SIAPAV, and the undersigned. Critical issues emerged, often related to the lack of connections between the various bodies responsible for the assistance of these particular patients. The session concluded with the proposal of a harmonious sharing of intentions, without personalisms, between ‘public’ and ‘private’, solely in the interest of the patient.
The second day concluded with the ordinary assembly of ITALF members, which approved the budget and a series of new initiatives, including the Association’s adhesion to a project dedicated to the creation of a ‘Lymphological and Lipedema Platform’ that will use artificial intelligence.
The third day opened with a lecture by Perrini, who presented some aspects of the new pharmacological approach to obesity in Lipedema with GLP1 analogues, a topic that is highly debated today due to the pros and cons this therapy entails, especially in the chronic management of the disease.
Following this, Sbarbati presented magnificent images with electron microscopy of normal and pathological adipose tissue, and Serena Michelini described all aspects that define Lipedema as an inflammatory disease of adipose tissue/organ. Cestari and Mander then presented the most common ultrasound findings observed in patients with Lipedema, with particular reference to fascial mutations and the accumulation of fluid components between the adipose septa of pathological tissue, which justifies the term ‘Lipedema’.
Vaia, for the surgical aspects specifically indicated in the treatment of the disease, and Cannataro, for the nutritional ones which have equally therapeutic value, then clarified other important aspects concerning the treatment of the disease.
But before the master lecture on the clinical examination of patients with Lipedema, presented by José Luis Simarro, Nunzia Ciarfera presented the text ‘Lipedema: Knowing it, Managing it, Treating it. A Map in the Labyrinth’, written by the LIO association with a wide range of scientific viewpoints, among the most widely followed internationally.
The last session was dedicated to ‘The Lymphatic System and Tumors. Current Issues in the Era of Oncological Oblivion’, where Tamburini, Boccardo, Manca, Marzo, and Salamé explained the new surgical and radiotherapeutic approaches. In an adjacent room, numerous scientific communications and complex clinical cases were also presented.
Thanking all attendees and all who made the event possible (Companies, Organizing Secretariat, On-site Technicians, national and international speakers, and participants), Manuela Sciuscio, an excellent organizer and coordinator of the work carried out, then closed the Congress, which can be revisited, for those interested, in a few weeks on the Association’s website, fully recorded.
Sandro Michelini
President of ITALF
Lecce June 21, 2025
