[TREATMENT OF POST-MASTECTOMY UPPER LIMB LYMPHEDEMA BY MODIFIED SIDE-TO-END LYMPHATICOVENULAR ANASTOMOSIS]

To investigate the therapeutic effect of modified side-to-end lymphaticovenular anastomosis in the treatment of post-mastectomy upper limb lymphedema.

Between May 2010 and May 2011, 11 female patients with post-mastectomy upper limb lymphedema underwent a modified side-to-end lymphaticovenular anastomosis. The average age was 49.5 years (range, 38-55 years). Lymphedema occurred at 7-30 months (mean, 18.3 months) after resection of breast cancer, with an average disease duration of 25.5 months (range, 10-38 months). The left upper limb was involved in 5 cases and the right upper limb in 6 cases. In accordance with difference value between health and affected sides criteria, 5 cases were rated as moderate, and 6 cases as severe.

Modified side-to-end lymphaticovenular anastomosis was successfully completed in all patients. Primary healing of incision was obtained in the other patients except 1 case of delayed healing. All patients were followed up for an average of 38.4 months (range, 36-40 months). Limb pain and swelling were relieved; no episodic attack or recurrence was observed. The circumference of affected upper arm was significantly decreased from preoperative (33.9 ± 3.7) cm to postoperative (31.0 ± 3.5) cm at 6 months and (30.9 ± 3.5) cm at 36 months (P < 0.05), but no significant difference was found between at 3 and 6 months (P > 0.05); the circumference of affected forearm was significantly decreased from preoperative (30.1 ± 3.6) cm to postoperative (27.8 ± 3.4) cm at 6 months and (27.7 ± 3.3) cm at 36 months (P < 0.05), but no significant difference was shown between at 6 and 36 months (P > 0.05). According to Campis evaluation standard to assess efficacy, the results were excellent in 3 cases, good in 6 cases, and improved in 2 cases

n Using modified side-to-end lymphaticovenular anastomosis may be effective in the treatment of upper limb lymphedema after mastectomy.