Results of surgical treatment of massive localized lymphedema in severely obese patients

Abstract

OBJECTIVE: to evaluate the importance of treatment of deformities caused by massive localized lymphedema (MLL) in the severely obese. METHODS: in a period of seven years, nine patients with morbid obesity and a mean age of 33 years underwent surgical resection of massive localized lymphedema with primary synthesis. This is a retrospective study on the surgical technique, complication rates and improved quality of life. RESULTS: all patients reported significant improvement after surgery, with greater range of motion, ambulation with ease and more effective hygiene. Histological analysis demonstrated the existence of a chronic inflammatory process marked by lymphomonocitary infiltrate and severe tissue edema. We observed foci of necrosis, formation of microabscesses, points of suppuration and local fibrosis organization, and pachydermia. The lymphatic vessels and some blood capillaries were increased, depicting a framework of linfangiectasias. CONCLUSION: surgical treatment of MLL proved to be important for improving patients' quality of life, functionally rehabilitating them and optimizing multidisciplinary follow-up of morbid obesity, with satisfactory surgical results and acceptable complication rates, demonstrating the importance of treatment and awareness about the disease.

Surgical treatment of a penoscrotal massive localized lymphedema: Case report

“…There`s a belief of benefit from lymphatic anastomosis and lymph node transplantation on mild to intermediate cases [11,13,14]. Conversely, most of publications relate the treatment of advanced cases, when the radical resection is the only and gold standard procedure done [4,[11], [12], [13], [14], [15], [16], [17]].…”

“…Whereas, the penile body skin reconstruction differs according to the author, despite the common successful result in long term follow-up, with markedly increase on patient`s quality of life. Irdam et al and Torio-Padron et al exposed the use of adjacent healthy skin to penile coverage [15,17,18]. Local pediculated flaps are other satisfying reconstructive options [12,13,16,19].…”

Concurrent bariatric surgery and surgical resection of massive localized lymphedema of the thigh. A case report

“…A bariatric surgical procedure results in a more significant improvement in obesity-related comorbidities and weight loss when compared to non-surgical interventions [12]. Surgical resection of MLL will allow the patient to be rehabilitated more effectively, prevent recurrent infections, restore mobility and improve patient's quality of life [13,14]. However, complications of surgical resection of MLL such as wound dehiscence, wound infection, and local recurrence has to be taken into account, preferably in a multidisciplinary manner [13].…”