Microsurgical lymphovenous anastomosis for treatment of chronic lymphedema of the lower extremity

ABSTRACT

Lymphovenous anastomosis [LVA] offers ideal physiologic treatment for lymphedema. Between January 1995 and November 1998, 36 patients underwent operation for chronic lymphdema. LVA could be performed in 30 patients [20 women and ten men]. Twenty two patients had secondary lymphedema [sixteen of them had filariasis and 6 patients had lymphedema after inguinal lymphadenectomy] and eight had primary lymphedema. The median duration of lymphedema in these patients was 5 years. Mean follow up was 30 months. Limb circumference, number of postoperative episodes of cellulitis, lymphoscintigraphy and patient satisfaction with the result were used to assess results. Improvement occurred in twenty two patients [73.3%]; twenty patients of them had secondary lymphedema [90.9%] and two patients had primary lymphedema [25%]. There was no change in seven extremities [23.3%], and in one patient with primary lymphedema the edema progressed [3.3%]. Therefore, we recommend this procedure in the early stage of the disease [grade 1and 2] in patients with secondary lymphedema