Summary
Background
Lymphoedema of the upper limb is a well-recognised complication of axillary surgery
for breast cancer. Effective long-term treatment of lymphoedema by liposuction has
previously been demonstrated. In this study we present our first five years of experience
using this technique in treatment of upper limb lymphoedema.
Methods
A prospective analysis of the results of 12 patients who underwent liposuction followed
by compression therapy for chronic unilateral upper limb oedema with up to five years
of follow-up was carried out. Hospital Anxiety and Depression Score questionnaires
and a Visual Analogue Score for overall well-being were also completed pre- and post-operatively.
Results
The mean duration of lymphoedema was seven years (range, 1–14), commencing at a mean
of one year (range, 0–5) after axillary surgery. The mean excess arm volume at admission
was 1391 ml and the ratio of the lymphoedematous to the unaffected arm was 1·48. The
mean total aspirate volume was 1713 ml, of which 87 percent was fat. At one year the
mean percentage volume reduction compared with the normal arm was 101 percent, meaning
that the volume of both of patients’ arms was virtually equivalent, and this reduction
was stable with up to 5 years of follow-up. Postoperatively there were reductions
in anxiety (p < 0.05) and depression scores, and an improvement in overall well-being.
Discussion
Our first five years of experience of liposuction combined with application of compression
garments has demonstrated significant, reproducible, and stable reduction of upper
limb oedema with improvement of overall well-being and reduction in measurable anxiety
and depression.
Keywords
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Article info
Publication history
Published online: February 28, 2012
Accepted:
January 26,
2012
Received:
July 22,
2011
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
