Innovative procedure in surgical management of chronic lymphoedema

Abstract

Background: Lymphoedema is the result of impaired lymphatic drainage from the affected organ. This abnormality can be primary or secondary. Different non-operative and operative approaches have been introduced to treat chronic lymphoedema. In the present study, we describe a new surgical technique and compare its results with other more commonplace methods. Materials and Methods: The study included 296 patients who had been diagnosed with chronic lower extremity lymphoedema and who had not responded to non-operative management for at least 6 months. Data was collected over 15 years, between March 1987 and March 2002. Doppler ultrasonography of the deep venous system was routinely undertaken in all patients to confirm its patency. The 296 patients underwent surgery and their progress was followed for at least 1year postoperatively. Results: All of the patients were operated on using our new technique, which is a modified form of the Homan techniques. The outcome was excellent, and 89.2% of patients were free of complication. The most common complication was wound seroma. Conclusions: Considering the difficulties associated with the treatment of chronic lymphoedema and the variety of surgical options, our method achieves excellent results, and could even become the standard operative procedure for treating intractable forms of disease. © Journal compilation © 2009 College of Surgeons of Hong Kong.