About an extreme case of giant lymphoedema of the upper limb: ligasure may be useful and a multidisciplinary approach is mandatory

• Published in: Annales de chirurgie plastique et esthétique 2011-08, Vol.56 (4), p.325-328
• Main Authors: Lafosse, A, Vandeputte, C, Sabor, I, Mahaudens, P, Denoel, C
• Format: Article
• Language: fre
• Subjects: Aged; Axilla - pathology; Axilla - surgery; Breast Neoplasms - surgery; Breast Neoplasms - therapy; Female; Follow-Up Studies; Humans; Interdisciplinary Communication; Ligation; Lymph Node Excision - adverse effects; Lymphedema - etiology; Lymphedema - pathology; Lymphedema - surgery; Mastectomy - adverse effects; Physical Therapy Modalities - adverse effects; Suture Techniques; Treatment Outcome; Upper Extremity - pathology; Upper Extremity - surgery
• ISSN: 1768-319X
• DOI: 10.1016/j.anplas.2010.10.011

Treatment of giant lymphoedema remains very difficult. The main problem is not only the obtention of early postoperative favorable results but to keep them long-lasting. The available treatment options are numerous and often combined. The indications have to be adapted to the clinical stage of the lesion. Ligasure(®) give us many advantages in the achievement of the surgical resection due to the quality of the lymphostasis that can be obtained and to the very limited thermic lesions caused to tissues. Long lasting postoperative physiotherapy is of first importance. We here describe a case of a giant lymphoedema of the upper limb after axillary lymph node dissection for breast cancer. The first physiotherapy failed, causing a lymphatic decompensation resulting in a lymphoedematous mass of nearly 7kg. The surgical resection with Ligasure(®) associated to drainage and compressive physiotherapy in the long run allows to obtain good results. The late follow-up after 4 years still shows stable results.