Department of Angiology

Therapy of Lymphedema

Since lymphedema causes lymph to collect in the tissue, the most important goal of any treatment is decongestion. In the early stages, it is advisable to elevate the affected body part as long as possible and repeatedly. Avoid tight clothing that exerts additional pressure on the tissue. In the case of secondary lymphedema, the cause must be found out and treated, such as the removal of a tumor.

Complex physical decongestive therapy

Complex physical decongestive therapy is helpful for primary lymphedema. This is a combination of manual lymphatic drainage, compression therapy using flat-knit compression stockings and special exercise therapy.

Decongestion can also be achieved by machine (intermittent pneumatic compression treatment). In this process, the affected person must put on special pants with pressure chambers. The pressure chambers gradually fill with air, creating a pressure wave. This activates the lymphatic vessels.

Surgical restoration of the lymphatic vessels

In very severe cases, doctors will try to restore lymphatic vessels surgically. However, they will recommend this surgery only after the combination of manual lymphatic drainage, compression therapy, exercise and respiratory therapy has been unsuccessful for more than six months. There are several surgical procedures to restore lymphatic vessels, here are the main ones mentioned:

  • The surgeon transplants the patient’s own lymph vessels and lymph nodes into the region of lymphedema. There she connects them to an artery and a vein to ensure blood supply. Such transplanted lymph nodes can then take over the drainage of the excess lymph.
  • The physician uses artificial connections of lymph vessels and veins to redirect the lymph (lymphovenous anastomoses) so that it flows partially through the blood vessels. Microsurgical procedures thus allow the drainage of water retention from the swollen region of the body.

Advances in reconstructive microsurgery make it possible to use even the smallest connecting vessels with diameters between 0.3 and 0.8 mm to restore lymphatic flow. The precision and dexterity of the surgeon’s hands is no longer the sole success factor. Robots are now already being used, enabling tremendous advances in supermicrosurgery.

What you can do yourself: Weight control and exercise therapy

Being overweight possibly increases the severity and progression of lymphedema. Therefore, as an affected person, try to reduce your body weight through appropriate balanced diet and exercise: Eat whole grains, legumes, vegetables, fruits and low-fat dairy products. Discuss with your health care provider what exercise training is right for you and where you can get support.

Studies have shown that, for example, lymphedema can be reduced or even prevented after breast cancer surgery with progressive strength training and combined dynamic exercise therapy.

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