Treatment of Lymphedema with Microsurgery

Lymph node dissection can, unfortunately, at times lead to lympedema of the arm or leg. The condition results in an excess of fluid in the limb, resulting in swelling. This can lead to inflammation and proliferation of cells and scarring of the affected tissue. Recurrent infection and loss of function can result.The degree of the lymphedema can vary, but it can become debilitating in some patients. In some cases, it can lead to recurrent infection.

The standard treatment for lymphedema is decongestive therapy, however it involves a significant investment in time, necessitating regular maintenance therapy.

Patients that have failed conservative treatment and have persistent lymphedema may be candidates for lymphovenous anastomosis and/or lymph node transplantation. Microsurgical lymphovenous anastomosis bypasses damaged lymph nodes by shunting lymphatic fluid directly to the venous system. Lymph node transplantation/free flap surgery relocates lymph nodes from just above the clavicle to the arm or leg. Both these procedures can in many cases lead to less swelling and help lessen the chance of recurrent infections.

Vascularized lymph node transplant and lymphovenous anastomosis were designed to improve outflow of lymphatic fluid and decrease the size of the affected limb. Results with lympovenous anastomosis and lymph not transplant have been promising to date.