Current Aspects of Surgical Treatment of Limb Lymphedema

Abstract

The article provides the literature overview on various current methods of surgical treatment of patients with limb lymphedema. Despite the fact that the basis of the treatment of this pathology is a complex antiedema therapy, the possibilities of conservative therapeutic measures for lymphedema leave much to be desired and cannot often satisfy either patients or clinicians. The use of surgical methods in the treatment of lymphedema has a long history and has gone from various types of resection to reconstructive interventions. The analysis of current literature data has shown that the choice of the volume and method of surgical correction in lymphedema requires a difficult and individual assessment of the pathological changes developing in the disease, which should be identified only with a comprehensive examination of patients. Operations of lymphovenous anastomosis, transplantation of lymph nodes are considered to be the most effective in the prevention or initial stages of lymphedema. With pronounced manifestations of the disease, optimal results are achieved with a reasonable combination of methods improving lymph drainage and operations reducing the excess volume of the affected limb, thereby provided patients with potentially improved functional outcomes and quality of life. The limitations in improvement despite multimodality treatment are consided to be at the level of satisfactory values. The experience of the most lymphedema professionals has to besuggesteda reasonable balance between basic conservative therapy and surgical treatment. Undoubtedly, the results of evaluating these methods will improve the choice of the optimal method for treating patients with limb lymphedema.