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Liposuction as an effective treatment for lower extremity lymphoedema: A single surgeon's experience over nine years
1Department of Plastic and Reconstructive Surgery, Ninewells Hospital, Dundee, United Kingdom.
Background:
Lymphoedema is a chronic, debilitating condition caused by a compromised lymphatic system. In recent years, the success of treating upper extremity lymphoedema with liposuction has been translated to patients with lower extremity lymphoedema (LEL), yet there remains a paucity of clinical evidence firmly supporting its use within this patient group.
Methods:
69 patients with LEL (72 legs) were consecutively treated with liposuction by a single surgeon. Compression garments were applied in theatre and continued postoperatively.
Results:
Mean preoperative volume of oedema was 4372 mL (range 229-15,166 mL), and mean volume of aspirate was 4550 mL (range 575-12,150 mL). There were no major surgical complications. An average reduction in volume of leg oedema of 85% was found at 3 months (n = 72), 88% at 1 year (n = 60), 94% at 2 years (n = 41) and 90% at 5 years (n = 15).
Conclusions:
We have demonstrated that liposuction combined with continuous compression therapy (CCT) is a safe and effective technique for treatment of primary and secondary LEL, with a significant reduction of the original excess limb volume. Male patients with primary lymphoedema have the poorest outcomes. Limbs with secondary lymphoedema respond best to this treatment.
