Treatment of lymphedema of the extremities with lymphatico-venous anastomosis

Very encouraging results have been obtained over a number of years with direct lymphaticovenous anastomosis in the treatment of primary and secondary lymphoedemas of the limbs. 12 cases involving the upper and lower extremities have been treated since 1976. An account is given of the personal technique employed. This makes use of dioptric means of magnification, instruments, materials, and microsurgical techniques. In some instances, differences have been observed between the objective results and improvements in the subjective symptomatology, as well as between treatment of the upper limbs (enlarged arms after mastectomy) and both primary and secondary lower limbs involvement. The pre- and postoperative cautions required are explained, together with the indications for treatment. An explanation is offered of some of the failures observed.