Obstructive Lymphedema of Lower Limbs Can be Successfully Controlled by Silicone Tube Implants Replacing Obliterated Lymphatic Collectors

Objectives: Lymphedema of limbs is caused by partial or total obstruction of lymphatic collectors as a consequence of skin and deep soft tissues inflammation, trauma of soft tissues and bones, lymphadenectomy and irradiation in cancer therapy. The growing number of patients is a desperate challenge for introducing a simple effective method to be done in every hospital. We proposed to drain edema fluid accumulations by creating artificial pathways to non-obstructed regions by implantation of silicone lymphatics.

Aim: To present the 3 to over 6 year follow up results of therapy of lymphedema by subcutaneous implantation of silicone tubings in lower and upper limbs.

Methods: In a group of 150 patients with obstructive limb lymphedema after pelvic or axillary lymphadenectomy and irradiation because of uterine or breast cancer, following unsuccessful conservative therapy, silicone lymphatics were implanted subcutaneously.

Results: There was: a) immediate decrease of limb circumference and volume within days after implantation and stabilization of size for years, b) decrease of tissue stiffness enabling easy limb movements, c) maintenance of patency of tubings bypassing the lymph flow obstruction site, d) edema fluid flow into tubings upon external massage and its movement to tissues where it could be absorbed, e) lack of reaction to foreign body and control of inflammation using low doses of penicillin.

Conclusions: Simplicity of surgical procedure, fast decrease of limb edema and lack of tissue reaction to implant make the method worth applying in advanced stages of lymphedema in cohorts of patients in every surgical ward.