Intensive treatment of leg lymphedema.
BACKGROUND
Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary.


OBJECTIVE
The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema.


METHODS
Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value <0.05) being considered significant.


RESULTS
All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value <0.001). Losses of more than 90% of the lymphedema occurred in 9 (39.13%) patients; losses of more than 80% in 13 (56.52%), losses of more than 70% in 17 (73.91%) and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9%) of the edema.


CONCLUSIONS
The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees.
Pereira de Godoy
José Maria
JM
Department of Cardiology and Cardiovascular Surgery and professor of the post graduation course of Medicine School of São Jose do Rio Preto-FAMERP-Brazil.
Azoubel
Lina M O
LM
de Fátima Guerreiro de Godoy
Maria
M