Treatment of Peripheral Lymphedema

Ningfei Liu

Department of Plastic and Reconstructive Surgery, Shanghai Jiao Tong University School of Medicine, China

^*Correspondance to: Ningfei Liu 

 PDF  Full Text DOI: 10.25107/2474-1647.2228

Abstract

Few breakthroughs have been made in the treatment of lymphedema because of a lack of information about the embryonic development and physiological function of the lymphatic system, pathophysiology and prognosis of lymphedema, and a lack of sophisticated and high-resolution imaging methods. The indications and evidence for the safety and efficacy of current surgical treatments are not clear-cut. The present mainstream treatment for lymphedema is complex decongestive therapy. Recent advances in multimodal lymphatic imaging have improved the accuracy of diagnosis of lymphatic disorders, necessitating new requirements and expectations for the treatment of peripheral lymphedema, the ultimate goal being to achieve individually tailored treatment. Treatment of peripheral lymphedema must be based on the following principles: a) Distinguishing primary from secondary lymphedema. The function and structure of the lymphatic system differ substantially between these two conditions. Lymphatic vessel regeneration and selfrepair in primary lymphedema require further investigation. b) Paying particular attention to pathological changes and their evolution in lymphatic vessels in the affected area, such pathological changes (sclerosis) in lymphatic vessels (and maybe also in lymph nodes) possibly being irreversible. c) Including addressing pathological changes in lymphedema-affected tissues (including irreversible changes such as chronic inflammatory reactions, fibrosis, and fat deposition) among the treatment targets. Decreasing the expression of inflammatory cytokines in tissues and blocking their functions at the molecular level may provide a new insight into and approach to treating lymphedema.

Keywords

Lymphedema; Complex decongestive therapy; Microlymphatic surgery; Lymphatic imaging

Cite the article

Liu N. Treatment of Peripheral Lymphedema. Clin Surg. 2018; 3: 2228.