Physiologic surgery for lower limbs filarial lymphoedema

ABSTRACT

This study is an expansion of previously undertaken early surgical trials to test the efficacy of lymphnodovenous shunts [LNVS] for the treatment of filarial lymphoedema of the lower limbs. LNVS was carried out in fifteen patients suffering from lower limbs filarial lymphoedema over a 3.5 years period, after failed previous conservative therapy. Mean follow-up was 13.7 months. Eleven patients had benefit from this type of physiologic surgery as judged by regular postoperative limb circumference measurements, radio- isotope lymphoscanning and incidence of recurrent cellulitis or lymphangitis. The lymphnodovenous shunt [LNVS] represents an appealing therapeutic option in properly selected cases of [secondary] filarial lymphoedema of lower limbs. Larger series and longer follow- up are awaited to further confirm the durable efficacy of such procedure in a most challenging problem in vascular surgery