Lymphoedema therapy

As the lymph collects in the tissue in the case of lymphoedema, the most important aim of any treatment is decongestion. In the early stages, it is advisable to keep the affected part of the body elevated for as long as possible. Avoid tight clothing that exerts additional pressure on the tissue. In the case of secondary lymphoedema, the cause must be identified and treated, such as the removal of a tumor.

Complex physical decongestive therapy

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

Decongestion can also be performed mechanically (intermittent pneumatic compression treatment). Those affected have to wear special pants with pressure chambers. The pressure chambers gradually fill with air, creating a pressure wave. This activates the lymph vessels.

Surgical restoration of the lymphatic vessels

In very severe cases, doctors attempt to surgically reconstruct lymph vessels. However, they will only recommend this operation if the combination of manual lymph drainage, compression therapy, exercise and respiratory therapy has been unsuccessful for six months. There are several surgical procedures to restore the lymphatic vessels, the most important ones are mentioned here:

  • The surgeon transplants the body’s own lymph vessels and lymph nodes into the region of the lymphoedema. There it connects to an artery and a vein to ensure the blood supply. Such transplanted lymph nodes can then take over the drainage of the excess lymph.
  • The doctor redirects the lymph with artificial connections between lymph vessels and veins (lymphovenous anastomoses) so that it flows partially via the blood vessels. Microsurgical procedures thus enable the drainage of water accumulations from the swollen region of the body.

Advances in reconstructive microsurgery make it possible to use even the smallest connecting vessels with a diameter of between 0.3 and 0.8 mm to restore lymph flow. The precision and skill of the surgeon’s hands is no longer the sole success factor. In the meantime, robots are already being used to make huge advances in supermicrosurgery possible.

What you can do yourself: Weight control and exercise therapy

Being overweight may increase the severity and progression of lymphoedema. Therefore, as a person affected, try to reduce your body weight through a balanced diet and exercise: Eat whole grain products, pulses, vegetables, fruit and low-fat dairy products. Discuss with your doctor which exercise training is suitable for you and where you can get support.

Studies have shown that progressive strength training and combined dynamic exercise therapy can reduce or even prevent lymphoedema after breast cancer surgery, for example.

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