What is the role of manual lymphatic drainage in the treatment of lymphedema?

Updated: Mar 24, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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In Europe, the best available nonsurgical therapy is manual lymphatic drainage according to the Vodder and/or Leduc techniques. Compression garments are essential between treatments. Similarly, other authors advocate manual massage of the affected extremity; this recruits collateral vessels, allowing the accumulated lymph to be drained into neighboring regions with normally functioning lymphatics.

Comparing treatments for breast-cancer related lymphedema, Gurdal et al found that the effectiveness of manual lymphatic drainage combined with the use of a compression bandage was similar to that for a combination of intermittent pneumatic compression and self-lymphatic drainage. Both combination treatments in the study produced a similar, significant reduction in total arm volume, as well as significant improvements on test scores assessing emotional functioning, fatigue, and pain. Only patients in the manual drainage/compression bandage group, however, seemed to show improvement in global health status and in functional and cognitive functioning test scores. [70]

A randomized trial showed that modified complex decongestive physiotherapy is effective for preventing lower extremity lymphedema in cervical cancer patients following laparoscopic radical hysterectomy with pelvic lymphadenectomy. [71]

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