Microsurgery for Lymphedema


 

Upper-extremity lymphedema is a chronic condition of hand and arm swelling that can affect up to 16% of breast-cancer survivors.

  • Symptoms: swelling, heaviness, skin thickening and fibrosis, recurrent infections, pain, disability
  • Risk factors: axillary node dissection, radiation, obesity
  • Significantly impairs the survivor's quality of life and activities of daily living

While conventional management involving decongestive therapy to reduce the swelling does improve the symptoms, patients often require further treatment. The University of Colorado is now one of the few centers in the U.S. offering lymphovenous bypass, a procedure that diverts the congested lymphatic vessels into the patient's veins. This allows another route for the fluid in the arm/leg to drain. Patients are able to wear their compression garments more comfortably, and many are able to decrease their reliance on the garments.

Another option is a lymph node transfer, which involves harvesting healthy lymph nodes and transplanting them as vascularized flaps to replace the affected lymph nodes. Lymphedema patients should consult with a plastic surgeon to determine if either surgeries are right for them.