Cormier JN, Rourke L, Crosby M, Chang D, Armer J, et al.
Annals of surgical oncology. Date of publication 2012 Feb 1;volume 19(2):642-51.
1. Ann Surg Oncol. 2012 Feb;19(2):642-51. doi: 10.1245/s10434-011-2017-4. Epub 2011
Aug 24.
The surgical treatment of lymphedema: a systematic review of the contemporary
literature (2004-2010).
Cormier JN(1), Rourke L, Crosby M, Chang D, Armer J.
Author information:
(1)Department of Surgical Oncology, University of Texas MD Anderson Cancer
Center, Houston, TX, USA. jcormier@mdanderson.org
PURPOSE: A systematic review of the literature was performed to examine
contemporary peer-reviewed literature (2004-2010) evaluating the surgical
treatment of lymphedema.
METHODS: A comprehensive search of 11 major medical indices was performed.
Selected articles were sorted to identify those related to the surgical treatment
of lymphedema. Extracted data included the number of patients, specific surgical
procedure performed, length of follow-up, criteria for defining lymphedema,
measurement methods, volume or circumference reduction, and reported
complications.
RESULTS: A total of 20 studies met inclusion criteria; procedures were
categorized as excisional procedures (n = 8), lymphatic reconstruction (n = 8),
and tissue transfer (n = 4). The reported incidence of volume reduction of
lymphedema in these studies varied from 118% reduction to a 13% increase over the
follow-up intervals ranging from 6 months to 15 years. The largest reported
reductions were noted after excisional procedures (91.1%), lymphatic
reconstruction (54.9%), and tissue transfer procedures (47.6%). Procedure
complications were rarely reported.
CONCLUSIONS: A number of surgical approaches have demonstrated beneficial effects
for select patients with lymphedema. Most of these reports, however, are based on
small numbers of patients, use nonstandardized or inconsistent measurement
techniques, and lack long-term follow-up. The proposed benefits of any surgical
approach should be evaluated in the context of the potential morbidity to the
individual patient and the availability of surgical expertise. In addition,
although these surgical techniques have shown promising results, nearly all note
that the procedures do not obviate the need for continued use of conventional
therapies, including compression, for long-term maintenance.
DOI: 10.1245/s10434-011-2017-4
PMID: 21863361 [Indexed for MEDLINE]
