[Clinical experiences in the use of lymphovenous anastomoses in secondary lymphedema]

Secondary lymphedema of the arm after therapy for breast cancer has a frequency of about 30% in the Federal Republic of Germany. Many authors have performed lympho-venous anastomoses to release lymphostatic edema, most using microsurgical technique. In this paper the authors present microlympho-venous anastomoses done in a telescope-like manner and using fibrin glue. First this technique was applied to dogs, later to patients. Measurement of the limb and of the limb volume at different levels were done pre- and postoperatively. Investigations with radionucleides were undertaken in some cases to measure lymphatic clearance. The operations were performed under local anaesthesia with perioperative antibiotic prophylaxis. The procedure was well tolerated by the patients, achieving a reduction of the swelling of about 30%. Despite the short follow-up of only six months and the limited number of cases we feel that this type of therapy should be offered to patients with secondary lymphedema.