Circumferential suction‐assisted lipectomy in the treatment of primary and secondary end‐stage lymphoedema of the leg

Background The treatment of end‐stage lymphoedema of the leg is challenging, especially when conservative treatment fails and there is a large volume difference between the affected and unaffected legs. Circumferential suction‐assisted lipectomy (CSAL) has been described as a treatment option for en...

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Bibliographic Details
Published in:British journal of surgery 2017-01, Vol.104 (1), p.84-89
Main Authors: Lamprou, D.‐A. A., Voesten, H. G. J., Damstra, R. J., Wikkeling, O. R. M.
Format: Article
Language:English
Subjects:
Compression Bandages
Female
Follow-Up Studies
Humans
Lipectomy - methods
Lower Extremity - surgery
Lymphedema
Lymphedema - surgery
Male
Middle Aged
Patients
Postoperative Care
Sex Factors
Suction
Surgery
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Summary:Background The treatment of end‐stage lymphoedema of the leg is challenging, especially when conservative treatment fails and there is a large volume difference between the affected and unaffected legs. Circumferential suction‐assisted lipectomy (CSAL) has been described as a treatment option for end‐stage lymphoedema of the leg. Here, the long‐term results of CSAL in end‐stage primary and secondary lymphoedema of the leg were analysed. Methods This was a descriptive study of patients treated with CSAL for unilateral chronic irreversible lymphoedema of the leg. Compression therapy was resumed after surgery. Leg volumes were measured before surgery, and at 1, 6, 12 and 24 months after the procedure. Results A total of 47 patients with primary lymphoedema had a median preoperative volume difference between affected and unaffected legs of 3686 (i.q.r. 2851–5121) ml. Two years after surgery, this volume difference was reduced to 761 ml, a 79 per cent reduction. In the 41 patients treated for secondary lymphoedema, the median preoperative volume difference was 3320 (i.q.r. 2533–4783) ml, decreasing after 2 years to −38 ml (101 per cent reduction). The preoperative volume difference and the sex of the patient significantly influenced the final outcome after 2 years. The outcome was not related to BMI or other patient characteristics. Conclusion CSAL is an effective method for treating both primary and secondary lymphoedema of the leg. Seems to work
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.10325