Eine prospektive Studie zur operativen Therapie des Beinlymphödems

Microsurgical therapy of lymphedema of the leg – a prospective study

by Sophia Magdalena Weiß
Doctoral thesis
Date of Examination:2020-01-14
Date of issue:2020-01-08
Advisor:PD Dr. Gunther Felmerer
Referee:PD Dr. Gunther Felmerer
Referee:Prof. Dr. Lutz Kretschmer
Referee:Prof. Dr. Jörg Wilting
Persistent Address: http://dx.doi.org/10.53846/goediss-7799

 

 

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Abstract

English

Secondary lymphedema of the leg is a chronic and progressive disease which cannot be healed. In the industrialized countries the most frequent course of secondary lymphedema of the leg is preceding tumor surgery with irradiation of the pelvis, groin or leg. The goal of this prospective study was to compare three different surgical treatments comprising autologous transplantation of lymph vessels, autologous transplantation of supraclavicular lymph nodes and lymphovenous anastomoses. The postoperative outcome was evaluated by determining leg circumference, tissue bioimpedance (expressed as L-Dex) and tissue water content. The data was compared with patients’ quality of life as assessed through a questionnaire. In addition, we investigated the feasibility of using technical devices for examinations in an outpatient setting and their suitability for postsurgical follow-up. Between May 2012 and May 2015 we included 16 patients (1 man, 15 women) during 12-month postsurgical follow-up. No significant changes in average leg circumference values were observed. The average L-Dex value and average tissue water content decreased, respectively and also the average questionnaire score dropped. In summary, the findings suggest that the above-mentioned surgical procedures are good methods for treating secondary lymphedema of the leg, although none of the procedures was clearly superior. Moreover, the data indicate that the postoperative outcome has a positive impact on the patient’s quality of life.
Keywords: lymphedema surgery; microsurgery; autologous transplantation of lymph vessels; autologous transplantation of supraclavicular lymph nodes; lymphovenous anastomoses; leg circumference; tissue bioimpedance; tissue water content; quality of life
 
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