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Fig. 2 - Mean pre- and post-operative volume reduction.
The preoperative mean ratio between the volumes of the edematous and healthy legs was 1.4, rapidly declining to 1.0 at 1 year and less than 1 after one year.
Conclusion: Liposuction is an effective method for treatment of chronic, non-pitting leg lymphedema in patients who have failed conservative treatment. It is the only known method that completely reduces excess volume at all stages of lymphedema. The removal of hypertrophied adipose tissue is a prerequisite to complete reduction. The reduced volume is maintained through constant use of compression garments.
LYMPHATIC MICROSURGERY: CHALLENGES AND INNOVATION
BOCCARDO F, CAMPISI CC, MOLINARI L, SPINACI S, DESSALVI S, CAMPISI C
Unit of Lymphatic Surgery-Department of Surgery-IRCCS S. Martino – IST National Cancer Institute-University of Genoa, Italy
Introduction: This study aimed to report new clinical approaches to the treatment of lymphatic disorders by microsurgical techniques based on histological and immunohistochemical findings. The authors’ wide clinical experience in the treatment of patients with peripheral lymphedema by microsurgical techniques is reported.
Materials and Methods: Microsurgical methods included derivative multiple lymphatic-venous anastomoses injecting the BPV dye in different areas according to lymphedema stage and based on lymphoscintigraphic findings. In all patients, lymphatic and lymph nodal tissues were sent for histological assessment, together with specimen of the interstitial matrix. Diagnostic investigations consisted in venous duplex scan and lymphoscintigraphy. Results were assessed clinically by volumetry performed preoperatively and postoperatively at 3 to 6 months and at 1, 3, and 5 years.
Results: The outcome obtained in treating lymphedemas at different stages was analyzed for volume reduction, stability of results with time, reduction of dermatolymphangioadenitis attacks, necessity of wearing elastic supports, and use of conservative measures postoperatively.
Conclusions: Microsurgical multiple lymphatic-venous derivative techniques allow bringing about positive results in the treatment of peripheral lymphedema, above all in early stages when tissular changes are slight and allow almost a complete restore of lymphatic drainage.
THE EUROPEAN JOURNAL OF LYMPHOLOGY - Vol. XXVI - Nr. 72 - 2015
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