Surgical Intervention for Lymphedema

People who undergo oncologic surgery or radiation therapy that targets one or more lymph nodes may experience lymphedema as a result. Lymphedema occurs when the lymph fluid that carries waste from bodily tissue stops flowing efficiently. The interruption could be due to actual lymph node removal or to impairment resultant from cancer therapy. When the lymph fluid does not flow properly, swelling develops along the path of the nonfunctional lymph node or nodes. For patients who have undergone treatment for breast cancer involving an axillary lymph node, lymphedema may occur in an arm. The condition may develop in a leg if a lymph node or nodes are disrupted or removed as a part of cancer treatment for the bladder, prostate, or reproductive organs. The primary objective in cancer treatment is not to save lymph nodes but to eradicate a potentially deadly disease. The lymph backup that may follow successful cancer treatment can still be a frustrating problem.

Treating Lymphedema

Studies suggest that the swelling caused by lymphedema may be brought under control successfully when proper lymphedema treatment is started right away. Common modalities include lymphatic drainage by a lymph massage therapist, exercise, and compression. The hope is that early treatment can achieve significant improvement within 6 months of onset. However, this isn’t always the reality. Sometimes, surgical intervention is necessary. Dr. Patel is a plastic and reconstructive surgeon who specializes in complex reconstructive surgery, microsurgery, and peripheral nerve surgery. He has dedicated his professional career to rebuilding and restoring the body after cancer, trauma, and disease. Two ways in which he does this include lymphovenous bypass and vascularized lymph node transfer surgery.

Lymphovenous bypass surgery is a surgical technique in which the obstructed lymphatic vessel or vessels are bypassed. To achieve better lymph flow, the obstructed vessels are severed at the point of the obstruction and are connected to adjacent veins. Studies indicate that lymphovenous bypass surgery can achieve lasting benefits when performed during early-stage lymphedema. Vascularized lymph node transfer is a complex surgical procedure that involves the transfer of healthy lymph nodes from one part of the body to the affected region. The transferred lymph nodes are inserted into a vascularized flap to support their vitality as they serve as a permanent new pathway for lymphatic drainage to occur efficiently. The results of the transfer do take time to develop, sometimes as long as several months.

In the ideal situation, lymphedema treatment can begin early and remain consistent. If current therapies do not provide an optimal degree of relief, surgery may be the next best step. To learn more about lymphedema surgery, contact our office at Keck Medicine. At 323-442-7920, we can schedule a visit for you at our Los Angeles or Glendale office.