Can get 75% patients with early #Lymphedema free from compression and other treatments using #Microsurgery
Seems that LVA is the way forward for #prevention and #treatment of #Lymphedema #breastcancer
The key to effective microsurgical treatment for lymphoedema is early intervention. The worldwide consensus from the ESL meeting in Genoa was that early microsurgery is the only really effective treatment for preventing and treating lymphoedema. This data is from Takaumi Yamamoto in Japan. Takumi is a very talented young surgeon, who is committed to analyzing the results of microsurgery for lymphoedema in detail. The database he maintains (I have seen it first hand in Tokyo) is awesome. His research papers are well thought out, and have lead the way.
He looked at surgery for early stage disease, and found that 75% of patients can dispense with garments and other non-surgical treatments for their lymphoedema. In later stage patients (with over 10-15% increased volume), patients usually can’t stop other treatment, but they might be able to use lighter compression, or go for short periods without compression (for example, whilst on holiday).
One thing I didn’t tweet about (I was listening as well as tweeting, so please forgive me!), is the reduction in infections after surgery. Makoto Mihara, also from Japan, looked at patients for 1 year before microsurgery, and 1 year after microsurgery. He found that their rate of infections decreased by 90%.
Again, this is a remarkable result. 90% less infections on average. This study is now published in the British Journal of Surgery - see ncbi.nlm.nih.gov/pubmed/251...
The reduction of infections was also seen in more severe disease, so again, patients with severe disease can benefit from microsurgery for their lymphoedema, but might well not become free of their compression garments.
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