Microsurgery for treatment of peripheral lymphedema: long-term outcome and future perspectives.
Authors report over 30 years of their own clinical experience in the treatment of chronic peripheral lymphedemas by microsurgical techniques performed at the Center of Lymphatic Surgery of the University of Genoa, Italy. Over 1,500 lymphedema patients were treated with microsurgical techniques. Derivative lymphatic-venous techniques were most often used. For those cases where a venous disease was associated to lymphedema, reconstructive lymphatic microsurgery techniques were performed (lymphatic-venous-lymphatic-plasty). Objective assessment was undertaken by water volumetry and lymphoscintigraphy. Volume changes showed a significant improvement in over 83%, with an average follow-up of more than 10 years. There was an 87% reduction in the incidence of cellulitic attacks after microsurgery. Microsurgical lymphatic-venous anastomoses have a place in the treatment of peripheral lymphedema and should be the therapy of choice in patients who are not sufficiently responsive to nonoperative treatment. Improved results can be expected with operations performed at earlier lymphedema stages.
Campisi
Corradino
C
Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Genoa, Italy. campisicorradino@tin.it
Eretta
Costantino
C
Pertile
Davide
D
Da Rin
Elisa
E
Campisi
Corrado
C
Macciò
Alberto
A
Campisi
Mirko
M
Accogli
Susanna
S
Bellini
Carlo
C
Bonioli
Eugenio
E
Boccardo
Francesco
F
D000714:Anastomosis, Surgical / Q000379:methods; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006811:Humerus; D008137:Longitudinal Studies; D042601:Lymphatic Vessels / Q000601:surgery*; D008209:Lymphedema / Q000145:classification / Q000209:etiology / Q000601:surgery*; D008866:Microsurgery / Q000379:methods* / Q000639:trends; D011877:Radionuclide Imaging; D013997:Time Factors; D016896:Treatment Outcome; D014680:Veins / Q000601:surgery*