What is the role of physiologic 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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Answer

Physiologic procedures attempt to improve lymphatic drainage. Multiple techniques have been described, including omental transposition, buried dermal flaps, enteromesenteric bridging, lymphangioplasty, and microvascular lympholymphatic anastomosis. [84] None of these techniques has clearly documented favorable long-term results. Further evaluation is necessary.

Rarely, venous-lymphatic anastomosis is performed in patients with severe lymphedema and a functioning venous system. Reports in the literature suggest that this procedure is effective only in cases of secondary lymphedema. Prophylactic lymphovenous anastomosis has been performed in patients undergoing extensive pelvic lymph node dissection who have a high risk of developing lymphedema.


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