What is the role of surgery 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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As previously mentioned, surgical treatment is palliative, not curative, and it does not obviate the need for continued medical therapy. Moreover, it is rarely indicated as the primary treatment modality, but is instead reserved for patients who do not improve with conservative measures or for cases in which the extremity is so large that it impairs daily activities and prevents successful conservative management. [80] Lymphaticovenular anastomosis surgery can be used to reduce lymphedema severity in selected patients. [81] Combining a lymphaticovenular anastomosis operation with complex physical therapy during the same hospitalization may provide a good combination therapy for advanced lymphedema. [82]

In general, surgical procedures are classified as physiologic or excisional. However, many physiologic techniques include an excisional component, making it difficult to distinguish between the 2 approaches. [83]

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