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Is Lymphedema Curable with Surgery
Wei F. Chen, MD; Ying C. Ku, BS; Diane Jo, MA; Sonia Pandey, MD
Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation
2023-02-01
Presenter: Sonia Pandey
Affidavit:
This submission is original and has not been previously submitted at other major meetings.
Director Name: Wei Chen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Purpose: With recent advancements in lymphatic supermicrosurgery, lymphedema is no longer considered untreatable. However, the extent of improvement achievable through surgical intervention remains uncertain. Is a symptom-free state not requiring further treatment, or cure, possible? We aimed to investigate whether lymphedema cure is attainable in patients undergoing lymphedema reconstruction surgery.
Methods: All fluid-predominant lymphedema patients undergoing lymphaticovenular anastomosis (LVA) and vascularized lymph vessel transplant (VLVT) between February 2020 and March 2022 were included. Patients' baseline and postoperative states were assessed with relief of symptoms, clinical examination, and indocyanine green (ICG) lymphography. Postoperative evaluations were performed at 3, 6, 12-months, and annually after. Cure is defined as patients becoming free of lymphedema-related symptoms without further lymphedema therapy/compression.
Results: 77 patients (75 LVA, 2 VLVT) underwent lymphatic reconstruction during the study period. Five LVA patients were excluded due to lack of follow-up. Remaining 72 patients (57 female, 15 male) had mean age 54, BMI 25.7, and follow-up of 15 months. One VLVT patient developed postoperative cellulitis. All patients (n=72) reported satisfactory relief of symptoms with favorable correlating postoperative examination and ICG lymphographic findings. Three female patients (2 LVA and 1 VLVT), aged 62, 40, and 70, achieved cure, requiring no further treatments during the follow-up periods (15, 21, and 24 months).
Conclusion: Although uncommon, lymphedema cure is a clinical reality and can be achieved through surgical intervention.
