title: [47-year course of severe lymphedema of the right lower limb. 6 successive operations from 1941 to 1950. Satisfactory condition 36 years after the last operation].
abstract: Mrs. T... (born in 1920) consulted Pr R. Leriche in 1941 for severe lymphoedema of the right leg present since 1939 following fly bites. Elastic contention was insufficient. Lumbar sympathectomy performed in 1941, subcutaneous-aponeurotic resections of the lateral aspect of the leg in 1942, extended in 1946 (R. Leriche) and completed by a wide excision of the posterior aspect in 1948 (Pr Goinard, Alger) only provided temporary improvements. In 1949, five polyethylene tubes were inserted under the skin of the calf at the root of the thigh (Kunlin and Boely). Three catheters had to be removed after several months because of the risk of cutaneous perforation and secondary infection. In 1950, in view of the inadequate results, ten nylon threads were inserted into the subcutaneous tissue from the ankle to the lower abdominal wall and a very extensive resection of the subcutaneous tissue (to the level of the dermis) and the aponeurosis was performed on the medial aspect of the leg (K. and B.). A dramatic improvement was obtained, which persisted until the beginning of 1986, i. e. 36 years after this last operation. Unfortunately, oedema has gradually appeared in the other leg over the last 4 to 5 years. Despite the various treatments attempted, the volume of this leg is now greater than that of the operated leg and is associated with increasing discomfort for the patient (Table of measurements). A calcified sheath has formed around the two remaining polyethylene tubes.
mesh_terms: D000273:Adipose Tissue / Q000601:surgery; D000328:Adult; D002404:Catheterization / Q000379:methods; D004817:Epidermis / Q000601:surgery; D005260:Female; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications; D007866:Leg / Q000601:surgery*; D008209:Lymphedema / Q000209:etiology / Q000601:surgery*; D008722:Methods; D013562:Sympathectomy
vernacular_title: 47 ans d'évolution d'un lymphoedème important du membre inférieur droit. 6 opérations successives de 1941 à 1950. Etat satisfaisant 36 ans après la dernière opération.