Surgical management of chronic lymphedema; introducing an innovative procedure

ABSTRACT

Lymphedema is the result of impaired lymphatic drainage from the affected organ. This abnormality can be primary or secondary. Different nonoperative and operative approaches have been introduced to treat chronic lymphedema. In this study, we describe a new surgical technique and compare its results with other more commonplace methods. 59 patients with the diagnosis of chronic lower extremity lymphdema who had not responded to nonoperative management for at least 6 months, were included in the study. They were collected during 15 years between March 1987 and March 2002. Doppler ultrasonography of deep venous system to confirm its patency was routinely performed in the most of patients. Then, they underwent surgery and were followed for at least 1 year postoperatively. All the patients were operated by our new technique which is a modified form of the Homans. The outcome was excellent and 89.2% of patients were devoid of complication. A 10.8% total complication rate was inevitable. The most common complication was wound seroma. According to the difficulties with treatment of chronic lymphedema and variety of surgical options, our method can be an excellent and even the standard operative procedure to treat intractable forms of disease