Three cases of the secondary lower-extremity lymphedema treated with intensive drainage by complex decongestive physiotherapy during hospitalization for one week

ABSTRACT

<b>Introduction:</b> We report three cases of women who developed secondary lower-extremity lymphedema after surgery for endometrial cancer. The cancer stage was 2 as per the International Society of Lymphology risk stratification. <b>Case Reports</b> We performed intensive lymphdrainage of two-phase complex decongestive physiotherapy in each case during a 1-week hospitalization period. The average leg circumference at discharge improved to 92～96% from baseline. Case 1 After primary treatment, a 35-year-old woman presented with temporarily poor self lymphatic drainage during maintenance therapy, and her leg circumference progressively enlarged. However, the patient received reeducation for self lymphatic drainage and outpatient service for lymphedema regularly. Since then, the leg lymphedema has improved. Case 2 A 63-year old woman improved to 92% of baseline and continued an excellent self lymphatic drainage, maintaining 83% with her depression recovered 2.5 years after this hospitalization. Case 3 This case involved a 70-year-old woman in whom maintenance therapy progressed well without aggravation of lymphedema; however, she died in 1.2 years after the first phase treatment due to cancer recurrence. <b>Discussion:</b> Intensive care under short-term hospitalization (for one week) for lower-extremity lymphedema was effective. However, there was one patient in whom self lymphatic drainage became poor. The patients required long-term care for maintenance therapy after primary treatment.