Current International Trends of Surgical Treatment of Lymphedema

Lymphedema is initially treated conservatively. Proper education is effective to avoid, alleviate or postpone complications, but certain patients may still proceed to advanced lymphedema. The choice of surgical treatment is based on the stage of disease. The early stage patients can be treated with physiologic surgery such as lymphaticovenous anastomosis (LVA) or vascularized lymph node transfer (VLNT). The advanced stage patients can be treated with excisional treatment such as liposuction or radical reduction of lymphedema with preservation of perforator (RRPP) or modified Charles’ procedure. Many treatment modalities had been proposed in the literature with variable results, but none of them can be universally applied to all patients. We think that a treatment plan should be designed for an individual patient according to different disease severity.