The Surgical Treatment of Lymphedema: A Systematic Review of the Contemporary Literature (2004–2010)
- 24 August 2011
- journal article
- review article
- Published by Springer Science and Business Media LLC in Annals of Surgical Oncology
- Vol. 19 (2), 642-651
- https://doi.org/10.1245/s10434-011-2017-4
Abstract
A systematic review of the literature was performed to examine contemporary peer-reviewed literature (2004-2010) evaluating the surgical treatment of lymphedema. A comprehensive search of 11 major medical indices was performed. Selected articles were sorted to identify those related to the surgical treatment of lymphedema. Extracted data included the number of patients, specific surgical procedure performed, length of follow-up, criteria for defining lymphedema, measurement methods, volume or circumference reduction, and reported complications. A total of 20 studies met inclusion criteria; procedures were categorized as excisional procedures (n = 8), lymphatic reconstruction (n = 8), and tissue transfer (n = 4). The reported incidence of volume reduction of lymphedema in these studies varied from 118% reduction to a 13% increase over the follow-up intervals ranging from 6 months to 15 years. The largest reported reductions were noted after excisional procedures (91.1%), lymphatic reconstruction (54.9%), and tissue transfer procedures (47.6%). Procedure complications were rarely reported. A number of surgical approaches have demonstrated beneficial effects for select patients with lymphedema. Most of these reports, however, are based on small numbers of patients, use nonstandardized or inconsistent measurement techniques, and lack long-term follow-up. The proposed benefits of any surgical approach should be evaluated in the context of the potential morbidity to the individual patient and the availability of surgical expertise. In addition, although these surgical techniques have shown promising results, nearly all note that the procedures do not obviate the need for continued use of conventional therapies, including compression, for long-term maintenance.Keywords
This publication has 66 references indexed in Scilit:
- Lymphedema beyond breast cancerCancer, 2010
- Incidence, Treatment Costs, and Complications of Lymphedema After Breast Cancer Among Women of Working Age: A 2-Year Follow-Up StudyJournal of Clinical Oncology, 2009
- Breast Cancer-Related Chronic Arm Lymphedema Is Associated with Excess Adipose and Muscle TissueLymphatic Research and Biology, 2009
- Lymphedema: A primer on the identification and management of a chronic condition in oncologic treatmentCA: A Cancer Journal for Clinicians, 2009
- Estimating the Population Burden of LymphedemaAnnals of the New York Academy of Sciences, 2008
- Adipose Tissue Dominates Chronic Arm Lymphedema Following Breast Cancer: An Analysis Using Volume Rendered CT ImagesLymphatic Research and Biology, 2006
- Health‐related quality of life with lymphoedema: a review of the literatureInternational Wound Journal, 2005
- Long-Term Results after Microlymphaticovenous Anastomoses for the Treatment of Obstructive LymphedemaPlastic and Reconstructive Surgery, 1990
- The Treatment of Elephantiasis of the LegsNew England Journal of Medicine, 1936
- FURTHER EXPERIENCES WITH THE KONDOLÉON OPERATION FOR ELEPHANTIASISJAMA, 1918