ABSTRACT
Over the last eight years, the authors analyzed obstructive lymphedema of a unilateral
upper extremity in a total of 27 females, comparing the use of supramicrosurgical
lymphaticovenule anastomoses and/or conservative treatment. The most common cause
of edema was mastectomy, with or without subsequent radiation therapy for breast cancer.
As an objective assessment of the extent of edema, the circumferences of the affected
and opposite normal forearms were measured at 10 cm below the olecranon of the arm.
Twelve of these patients received continual bandaging. In these patients, the average
excess circumference of the affected arm was 6.4 cm over that of the normal forearm;
the average duration of edema before treatment was 3.5 years; the average period for
conservative treatment was 10.6 months; and the average decrease in circumference
was 0.8 cm (11.7 percent of the preoperative excess). Twelve patients underwent surgery
and postoperative continual bandaging. In these patients, the average excess circumference
was 8.9 cm; the average duration of edema before surgery was 8.2 years; the average
follow-up after surgery was 2.2 years; and the average decrease in circumference was
4.1 cm (47.3 percent of the preoperative excess). These results indicated that supermicrolymphaticovenular
anastomoses with postoperative bandaging have a valuable place in the treatment of
obstructive lymphedema.
