Results of surgical treatment of massive localized lymphedema in severely obese patients.
OBJECTIVE
to evaluate the importance of treatment of deformities caused by massive localized lymphedema (MLL) in the severely obese.


METHODS
in a period of seven years, nine patients with morbid obesity and a mean age of 33 years underwent surgical resection of massive localized lymphedema with primary synthesis. This is a retrospective study on the surgical technique, complication rates and improved quality of life.


RESULTS
all patients reported significant improvement after surgery, with greater range of motion, ambulation with ease and more effective hygiene. Histological analysis demonstrated the existence of a chronic inflammatory process marked by lymphomonocitary infiltrate and severe tissue edema. We observed foci of necrosis, formation of microabscesses, points of suppuration and local fibrosis organization, and pachydermia. The lymphatic vessels and some blood capillaries were increased, depicting a framework of linfangiectasias.


CONCLUSIONS
surgical treatment of MLL proved to be important for improving patients' quality of life, functionally rehabilitating them and optimizing multidisciplinary follow-up of morbid obesity, with satisfactory surgical results and acceptable complication rates, demonstrating the importance of treatment and awareness about the disease.
Clinics Hospital, Faculty of Medicine, University of São Paulo.
Wilson
W
Cintra Júnior
Clinics Hospital, Faculty of Medicine, University of São Paulo.
Miguel Luiz Antonio
ML
Modolin
Clinics Hospital, Faculty of Medicine, University of São Paulo.
Rodrigo Itocazo
RI
Rocha
Clinics Hospital, Faculty of Medicine, University of São Paulo.
Thadeu Rangel
TR
Fernandes
Clinics Hospital, Faculty of Medicine, University of São Paulo.
Ariel Barreto
AB
Nogueira
Department of Plastic Surgery, Faculty of Medicine, University of São Paulo.
Rolf
R
Gemperli
D000328:Adult; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013514:Surgical Procedures, Operative; D055815:Young Adult