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Microsurgery for lymphedema: Clinical research and long‐term results
Author(s) -
Campisi Corradino,
Bellini Carlo,
Campisi Corrado,
Accogli Susanna,
Bonioli Eugenio,
Boccardo Francesco
Publication year - 2010
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.20737
Subject(s) - medicine , microsurgery , lymphedema , surgery , anastomosis , lymphatic system , cellulitis , peripheral , cancer , pathology , breast cancer
Objectives: To report the wide clinical experience and the research studies in the microsurgical treatment of peripheral lymphedema. Methods: More than 1800 patients with peripheral lymphedema have been treated with microsurgical techniques. Derivative lymphatic microvascular procedures recognize today its most exemplary application in multiple lymphatic‐venous anastomoses (LVA). In case of associated venous disease reconstructive lymphatic microsurgery techniques have been developed. Objective assessment was undertaken by water volumetry and lymphoscintigraphy. Results: Subjective improvement was noted in 87% of patients. Objectively, volume changes showed a significant improvement in 83%, with an average reduction of 67% of the excess volume. Of those patients followed‐up, 85% have been able to discontinue the use of conservative measures, with an average follow‐up of more than 10 years and average reduction in excess volume of 69%. There was a 87% reduction in the incidence of cellulitis after microsurgery. Conclusions: Microsurgical LVA have a place in the treatment of peripheral lymphedema, and should be the therapy of choice in patients who are not sufficiently responsive to nonsurgical treatment. © 2010 Wiley‐Liss, Inc. Microsurgery, 2010.