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.
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.
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.
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.
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- Querci della Rovere G, Easton D, Westbury G. Risk of lymphoedema following the treatment of breast cancer.Br J Surg. 1986; 73: 580-584
- Conservative treatment of breast cancer: results of management of axillary lymph node area in 3353 patients.Lancet. 1985; 1: 1387
- Post-operative arm morbidity and quality of life: results of the ALMANAC randomised trial comparing sentinel node biopsy with standard axillary treatment in the management of patients with early breast cancer.Breast Cancer Res Treat. 2006; 95: 279-293
- Morbidity of sentinel lymph node biopsy (SLN) alone versus SLN and completion axillary lymph node dissection after breast cancer surgery: a prospective Swiss multicenter study on 659 patients.Ann Surg. 2007; 245: 452-461
- Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011.J Clin Oncol. 2007; 25: 3657-3663
- A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer.N Engl J Med. 2003; 349: 546-553
- Surgical complications associated with sentinel lymph node biopsy: results from a prospective international cooperative group trial.Ann Surg Oncol. 2006; 13: 491-500
- Quality of life following liposuction and conservative treatment of arm lymphoedema.Lymphology. 2006; 39: 8
- Overview of surgical treatments for breast cancer-related lymphedema.Plast Reconstr Surg. 2010 Dec; 126: 1853-1863
- Treatment of lymphedemas by microsurgical lymphatic grafting: what is proved?.Plast Reconstr Surg. 1990; 85: 64-74
- Micro-lymphatic bypass in the treatment of obstructive lymphoedema of the arm: Case report of a new technique.Br J Plast Surg. 1983; 36: 350-357
- Evaluation of transport kinetics in lymphoscintigraphy: follow-up study in patients with transplanted lymphatic vessels.Eur J Nucl Med. 1985; 10: 349-352
- Microsurgical lymphaticovenous implantation for the treatment of chronic lymphedema.Plast Reconstr Surg. 1998; 101: 157-161
- Microlymphaticovenous anastomoses for obstructive lymphedema.Plast Reconstr Surg. 1977; 60: 197-211
- Long-term results after microlymphaticovenous anastomoses for the treatment of obstructive lymphedema.Plast Reconstr Surg. 1990; 85: 562-572
- Supermicrosurgical lymphaticovenular anastomosis for the treatment of lymphedema in the upper extremities.J Reconstr Microsurg. 2000; 16: 437-442
- Lymphaticovenular bypass for lymphedema management in breast cancer patients: a prospective study.Plast Reconstr Surg. 2010 Sep; 126: 752-758
- Postmastectomy lymphedema: long-term results following microsurgical lymph node transplantation.Ann Surg. 2006; 243: 313-315
- Vascularized groin lymph node transfer using the wrist as a recipient site for management of postmastectomy upper extremity lymphedema.Plast Reconstr Surg. 2009; 123: 1265-1275
- Adipose tissue dominates chronic arm lymphedema following breast cancer: an analysis using volume rendered CT images.Lymphat Res Biol. 2006; 4: 199-210
- Liposuction in the treatment of lymphoedema: a preliminary report.Br J Plast Surg. 1989; 42: 530
- Liposuction in arm lymphedema treatment.Scand J Surg. 2003; 92 ([Review]): 287-295
- Complete reduction of lymphoedema of the arm by liposuction after breast cancer.Scand J Plast Reconstr Surg Hand Surg. 1997; 31: 137
- Liposuction combined with controlled compression therapy reduces arm lymphoedema more effectively than controlled compression therapy alone.Plast Reconstr Surg. 1998; 102: 1058
- Circumferential suction-assisted lipectomy for lymphoedema after surgery for breast cancer.Br J Surg. 2009 Aug; 96: 859-864
- Liposuction reduces arm lymphedema without significantly altering the already impaired lymph transport.Lymphology. 1998 Dec; 31: 156-172
- Liposuction technique and lymphatic lesions in lower legs: anatomic study to reduce risks.Plast Reconstr Surg. 1999; 103 (discussion pp. 1874–1875): 1868-1873
- Diagnosing cancer related lymphoedema in the arm.J Lymphoedema. 2006; 1: 12-15
- Upper-extremity volume measurements in women with lymphedema: a comparison of measurements obtained via water displacement with geometrically determined volume.Phys Ther. 2002; 82: 1202-1212
- Breast cancer-related chronic arm lymphedema is associated with excess adipose and muscle tissue.Lymphat Res Biol. 2009; 7: 3-10
Published online: February 28, 2012
Accepted: January 26, 2012
Received: July 22, 2011
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.