A Case Report of Severe Lymphedema of Lower Limb: Surgical Management

Authors

  • Ruch Wongtrungkapun Department of Surgery, Bamrasnaradura Infectious Disease Institute, Ministry of Public Health

Keywords:

Lymphedema, elephantiasis, debulking, stage surgery

Abstract

Background: Secondary lymphedema usually resulted from damage of the lymphatic system. Common causes include surgery, trauma, radiation, or infection. One obvious example is arm edema after breast surgery or radiation treatment of some cancers. Currently, there was no definite treatment for lymphedema. Treatment goal is to restore function, reduce physical and psychological suffering, and prevent the development of complications. There are two alternative approaches for surgery: reconstructive surgery and destructive surgery.

Objective: To report a successful lymphedema case treated with debulking surgery of lower limb lymphedema.

Method: A case report

Result and Conclusion: Elephantiasis can divide into two types; primary and secondary. Both pathogenesis ended up with persistent edema of the tissue. Conservative measures are usually not curative for elephantiasis, while the surgery will help to restore patient’s function. There are two types of surgery for elephantiasis; reconstructive of lymphatic structure and destructive debulking surgery. In this case report, debulking surgery can be an adjuvant technique for elephantiasis.

References

1. Brennan MJ. Lymphedema following the surgical treatment of breast cancer: a review of pathophysiology and treatment. J Pain Symptom Manage 1992;7:110-6.

2. Földi M, Földi E, Kubik S. Textbook of lymphology: for physicians and lymphedema therapists. Munich, Germany: Elsevier; 2003.

3. The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology 2013;46:1-11.

4. Piller N, Carati C. The diagnosis and treatment of peripheral lymphedema. Lymphology 2009 Sep;42:146-7.

5. Cormier JN, Rourke L, Crosby M, Chang D, Armer J. The surgical treatment of lymphedema: a systematic review of the contemporary literature (2004-2010). Ann Surg Oncol 2011;19:642-51.

6. Lee BB, Kim YW, Kim DI, Hwang JH, Laredo J, Neville R. Supplemental surgical treatment to end stage (stage IV-V) of chronic lymphedema. Int Angiol 2008 Oct;27(5):389-95.

7. Wollina U, Heinig B, Schonlebe J, Nowak A. Debulking surgery for elephantiasis nostras with large ectatic podoplanin-negative lymphatic vessels in patients with lipolymphedema. Eplasty 2014;14:e11.

8. Mehrara BJ, Zampell JC, Suami H, Chang DW. Surgical management of lymphedema: past, present, and future. Lymphat Res Biol 2011;9:159-67.
vol38no1

Downloads

Published

2017-03-30

How to Cite

1.
Wongtrungkapun R. A Case Report of Severe Lymphedema of Lower Limb: Surgical Management. Thai J Surg [Internet]. 2017 Mar. 30 [cited 2024 Nov. 22];38(1):39-45. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/219948

Issue

Vol. 38 No. 1 (2017): January - March

Section

Case Reports

License

Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.