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Lymphatic reconstructive surgery

Lymphoedema is nothing more than an accumulation of fluid (lymph) in a limb due to an interruption or alteration of the lymphatic system . Upper extremity lymphedema may be congenital, although the most common causes, in our experience, are the consequences of cancer treatment (breast cancer, melanoma, sarcomas ...). Other less common causes are certain infectious processes such as filaria.

Approximately 10% of patients treated for breast cancer (radiotherapy, axillary lymph node dissections, sentinel node) develop lymphedema in the upper extremity. This may not necessarily develop immediately after surgery but may take some time, even years before it becomes visible.  

Lymphoedema has been managed, until recently, only with conservative treatments such as massages and placement of compression bandages.  We currently have some new surgical techniques that have really encouraging results:

Microsurgical lymph-node transfer

This technique involves removing healthy lymph nodes on the vascular pedicle from the body part where they are expendable, such as superficial inguinal area, and their transfer to the armpit with a microsurgical techniques.  This technique is performed under general anesthesia and the patient should remain hospitalized for 3-4 days..

Microsurgical lymphatico-venous anastomosis

This technique consists of joining the lymphatic vessels and subdermal superficial veins of the affected limb through small skin incisions. Thus the lymphatic system can drain directly to veins to decrease the lymphoedema. This second option can be performed under local anesthesia and the patient should be admitted for 1 day.

Following these interventions patients should undergo a rehabilitation program. Lymphoedema is important to treat during the first year, when it has not yet been established and there is no residual fibrosis. This produces the most satisfactory results