Lower extremity lymphedema secondary to oncological treatment: Update on diagnosis and surgical treatment

Abstract

Lower extremities secondary lymphedema is the accumulation of protein-rich fluid in the interstitium as a consequence of the damage of lymphatic vessels. In our country, it is more frequently related to the surgical treatment of cancer. The incidence varies depending on the type of cancer and the treatment received, with an increased risk in cases in which lymphadenectomy and radiotherapy are performed. Clinical diagnosis and imaging techniques are essential to asses the functional status of the lymphatic system. The main objectives in the management of lymphedema are to limit patient morbidity, improve functionality and quality of life. There are procedures that seek to prevent the development of lower extremity lymphedema. Once established, the treatment can be conservative and surgical. Surgical treatment includes physiological (reconstructive) and excisional procedures. Success depends on a good selection of patients and the performance of an individualized treatment. The following is a review regarding the incidence, risk factors, diagnostic strategies and surgical techniques with emphasis on microsurgical treatment.