A microsurgical method for reconstruction of interrupted lymphatic pathways: autologous lymph-vessel transplantation for treatment of lymphedemas

Abstract

Refinements in microsurgery have made it possible to perform causal therapy on lymphedemas due to a local blockade of lymphatic pathways through transplantation of the patient's lymph collectors. End-to-end anastomoses with lymphatics before and after the blockade or crossing to the opposite side are performed under 40-fold magnification. Between July 1980 and February 1985 32 patients received this treatment. 23 patients had postmastectomy edema, and 9 patients had unilateral edema of the lower limb (2 primary, 7 secondary edemas). The lasting result was that the volume difference between the affected and the healthy limb decreased to about 65%. Lymphatic scintiscans showed improved lymphatic transport capacity with increasing time from surgery and long patency of the grafts.