Lymphedema: Causes and treatment advances

Lymphedema is an abnormal accumulation of lymph fluid that occurs in women who have undergone surgery to beat breast cancer. It is a chronic, progressive disorder of inflammation in the arms to be prevented and diagnosed as soon as possible to treat it.

Causes and origin of lymphedema

The incidence of the occurrence of upper extremity lymphedema after surgical treatment of breast cancer is very variable, being published data between 6 and 60% depending on the population studied, the measurement criteria and the follow-up period. Its main source is the disruption of lymphatic vessels during surgery for breast cancer, but also secondary lymphedema may appear as a result of treatment of other tumors such as melanoma or sarcoma.

A common feature of these types of tumors is the spread of disease via the lymphatic system, with the consequent need to remove the regional lymph nodes.

Lymphedema affects the quality of life

In addition to increased volume in the affected extremity lymphedema it involves physical consequences as heaviness, discomfort and pain; and functional consequences, such as limitation of movement, the need for compression garments and increased frequency of infectious episodes in the limb.

Since the development of lymphedema depends on many factors, it practices it is very difficult to prevent. Therefore, in addition to applying all possible measures to reduce morbidity or surgical aggressiveness, as the technique of sentinel node, it is vital the close postoperative follow-up in order to establish an early diagnosis in if necessary the early establishment of medical and / or surgical treatment. In fact, a relevant lymphedemas longstanding established or chronified problem is the fact that tissue volume more long develop fibrosis and hardening, being that volume, nonreversible as fixed, even applying surgical treatment.

Treatment of Lymphedema

The treatment of lymphedema is twofold: the rehabilitation treatment and surgery.

Rehabilitation treatment is the use of compression garments to contain the accumulation of liquids; and lymphatic drainage massage to try to reduce the liquid before it becomes chronic. This physical and rehabilitative treatment is essential to prevention and early control.

Unfortunately, sometimes it fails to prevent and the problem becomes complicated. For these cases the Plastic Surgery has provided several surgical techniques have been developed in recent years and continue in further research and development.

Surgical options for the treatment of lymphedema passes today for two main procedures:

1 The lymphatic-venous anastomosis:Since the lymphatic pathway has been limited in its course at the level of the armpit or groin, in the case of the legs, the idea that arises is to try to redirect the lymph flow before locking into the superficial venous system. This is accomplished by connecting suture or one or more lymphatics with neighboring small venules. This surgery is usually performed in several operations over 6 to 12 months.Such connections require supermicroquirúgica technique performed under surgical microscope and a instrumental suture material and extremely fine.

2nd transfers lymph-nodal complex units:In this option, the idea is to transfer groups of carriers fatty tissue of lymph nodes and their corresponding lymphatics, taken from healthy areas, and connect them to blood vessels receptors on the problem area. The aim is not only to try to improve fluency in lymphatic drainage, but also provide healthy tissue to generate a new defensive barrier in the damaged area.

It is crucial for the professionals help information, dissemination and awareness of this problem and treatment options available in order to promote better prevention and early detection of this chronic problem that currently affects many women.

Edited by Roser Berner Ubasos.