Excisional surgery for chronic advanced lymphedema.
OBJECTIVE
We conducted a retrospective study to evaluate the efficacy of excisional surgery to treat chronic advanced lymphedema. Excisional surgery was performed to reduce the extremity size, improve limb function, and decrease the frequency of lymphangitis and prevent sepsis.


METHODS
Between August 1997 and December 2001, we performed excisional surgery on one or two affected legs in 20 patients with chronic lymphedema (total 24 legs). The lymphedema was graded as stage III in 5 extremities and as stage IV in 19 extremities. Five patients had primary lymphedema and 15 had secondary lymphedema. The mean duration of follow-up was 17.8 months.


RESULTS
Excisional surgery resulted in clinical improvement in 18 extremities, all of which received regular physiotherapy after surgery. However, lymphedema progressed to the preoperative status in six extremities, four of which did not receive regular physiotherapy after surgery.


CONCLUSIONS
Excisional surgical therapy can be effective for chronic advanced lymphedema, but appropriate postoperative physiotherapy is essential to ensure that the effects last.
Kim
Dong-Ik
DI
Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
Huh
Se-Ho
SH
Hwang
Ji-Hye
JH
Joh
Jin-Hyun
JH
D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg; D008209:Lymphedema / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011182:Postoperative Care; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors