What is lymphedema?
Lymphedema is caused by a deficiency in the lymphatic system, whereby lymph does not flow properly and remains accumulated in the interstitial spaces of the subcutaneous cellular tissue. Consequently, this failure produces an increase in volume in the affected limb or body part where the lymphedema occurs. There are two types:
- Primary lymphedema: occurs when the lymph ducts and/or lymph nodes are unable to transport large proteins or other molecules into the venous stream. It usually appears in the lower limbs.
- Secondary lymphedema: is due to the removal of one of the lymph nodes in an area, which hinders lymphatic drainage. The most common appear in the upper limbs, especially after breast cancer surgery.
Prognosis of the disease
Once lymphedema develops, healing is very difficult. In addition, it poses a deficit in quality of life that increases over time. Stabilizing the situation with compression garments can improve the quality of life of these patients. Preventive measures for this pathology can reduce the symptoms and delay or stop the progression of the disease to prevent future complications.
Symptoms of lymphedema
The main symptom is an increase in the size of the area affected by lymphedema. In addition, this swelling may be accompanied by discomfort, a feeling of heaviness, difficulty in mobility, fibrosis and vascular alterations.
The main symptom is an increase in the size of the affected area.
Medical tests for lymphedema
If there is a risk of lymphedema, the specialist in Vascular Surgery may suggest tests depending on the symptoms you present. Some of them are:
- Magnetic Resonance Imaging (MRI)
- Computed Tomography (CT)
- Doppler ultrasound
- Lymphatic system scintigraphy.
What are the causes of lymphedema?
There are several factors that cause lymphedema, among them, processes, infections or congenital diseases. However, its main origin is the interruption of the lymphatic vessels during breast cancer surgery, which causes the swelling of the arms and its consequent disability. Another of the main causes is the decrease of the lymphatic ducts from birth, which causes a congenital difficulty of drainage. These tend to manifest themselves more commonly in women after adolescence.
Can it be prevented?
Prevention consists of maintaining good lymph drainage through specific exercises, avoiding standing for long periods of time, watching sun exposure, wearing loose-fitting clothing, not lifting excessive weights, etc.
Treatments for lymphedema
There is no specific cure for lymphedema, but there are treatments that can slow the progression and increase in volume. Currently, two lymphedema surgery procedures are available that can successfully resolve the condition:
- Microsurgical lymph node transfer: this consists of removing healthy nodes with blood vessels from another part of the body, such as the superficial groin area, and placing them in the axilla. In this way, the transferred vessels create a new drainage system and reduce the accumulated lymph.
- Microsurgical lymphatic-venous diversion: this is based on the union of the superficial lymphatic vessels with the subcutaneous veins of the affected limb. In this way, the lymph is diverted to the veins to unload the area of lymphedema.
What specialist treats it?
The vascular surgeon is in charge of treating pathologies of the vessels of the circulatory system, both at the arterial and venous level.