Circumferential suction-assisted lipectomy for lymphoedema after surgery for breast cancer.
BACKGROUND
The incidence of arm lymphoedema after treatment for breast cancer ranges from 1 to 49 per cent. Although most women can be treated by non-operative means with satisfying results, end-stage lymphoedema is often non-responsive to compression, where hypertrophy of adipose tissue limits the outcome value of compression or massage.


METHODS
This was a prospective study of 37 women with unilateral non-pitting lymphoedema. After initial conservative treatment for 2-4 days, circumferential suction-assisted lipectomy was used to remove excess volume. Limb compression was resumed after surgery with short-stretch bandages, followed by flat-knit compression garments.


RESULTS
The mean preoperative excess arm volume was 1399 ml. The total aspirate volume was 2124 ml with 93 per cent aspirate adipose tissue content. After 12 months, the mean reduction in excess volume was 118 per cent. The percentage reduction in excess volume after 12 months was linearly related to the preoperative excess volume but showed no linear relationship with the duration of lymphoedema or surgeon experience.


CONCLUSIONS
Circumferential lipectomy combined with lifelong compression hose is an effective technique in end-stage lymphoedema after treatment for breast cancer.
Damstra
R J
RJ
Department of Dermatology, Phlebology and Lymphology, Nij Smellinghe Hospital, The Netherlands. r.damstra@nijsmellinghe.nl
Voesten
H G J M
HG
Klinkert
P
P
Brorson
H
H
D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D000368:Aged; D001132:Arm; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D007902:Length of Stay; D015187:Lipectomy / Q000379:methods*; D008209:Lymphedema / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies