Reconstructive microsurgery in treatment of lymphoedema in extremities.

A total of 510 cases of primary and secondary lymphoedema in upper and lower extremities have been examined with two thirds of primary lymphoedema cases among them. Radical mastectomy combined with irradiation has led to the development of obstructive lymphoedema of upper limbs in most patients. 230 patients with primary and secondary lymphoedema have been subjected to microlymphatic surgery and lymphaticovenous anastomoses have been carried out with microsurgical techniques. Limb volume measurement, the results of direct lymphangiography and intralymphatic pressure reading were taken into account to select patients suitable for microlymphatic surgery. Most favourable results have been obtained in secondary obstructive lymphoedema cases (total 81.2%) due to well-marked hypertension in lymphatic vessels that contributes to better functioning of the lymphaticovenous anastomoses made in a patient.