Treatment of gynaecological cancer related lower limb lymphoedema with liposuction
Pauline McGee, David Alex Munnoch. Gynecologic Oncology 2018
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Treatment of gynaecological cancer related lower limb lymphoedema with liposuction
Pauline McGee, David Alex Munnoch. Gynecologic Oncology 2018
Objective: To evaluate outcomes in patients with gynaecological cancer related lymphoedema treated with liposuction.
Methods: A prospective analysis of 21 patients who underwent liposuction followed by compression therapy for chronic unilateral lower limb lymphoedema with up to 8 years follow up was performed.
Results: Duration of lymphoedema prior to liposuction ranged from 4 to 28 years (mean 15.2 years). The mean age at time of liposuction was 52 years (range 37–67). Estimated volume excess in the affected limb ranged from 1.6 to 12 l (mean 4.7 l). The mean percentage reduction was 92.6% at 6 months (range 59.4–159.9) and 88.9% (range 60.9–127.5) at 1 year. Longer term follow-up of 6 patients at 5 years post-liposuction revealed a mean percentage reduction of 113.6% (range 83.5–155.5).
Conclusion: Our experience of liposuction combined with compression garments has demonstrated significant and sustainable reduction in limb volume in patients with lower limb lymphoedema secondary to gynaecological malignancy.
Main findings
- Liposuction is offered to patients whose swelling does not improve with conservative measures (compression therapy), are of International Society for Lymphoedema stage 2 or 3 and with a minimum of one litre volume excess.
- N = 21
- Post-operative limb volume continued to reduce with a mean percentage reduction of 87.51% at 3 months (range 31–178, SD 32.4, p value b 00001), 92.16% at 6 months (range 59.4–159.9, SD 24.2, p value b 0.00001) and 88.85% at 1 year (range 60.9–127.5, SD 20.4, p value b 0.00001). Longer term follow-up of 6 patients at 5 years post-liposuction revealed a mean percentage reduction of 113.59% (range 83.5–155.5, SD 28.9, p value b 0.00804) meaning clinically the operated leg was smaller than the unaffected side. Patient reported quality of life outcomes improved in the ten patients who completed LyQLi questionnaires
- Liposuction is an effective treatment for chronic lymphoedema with fat hypertrophy, patients require management in a unit familiar with liposuction as a treatment for lymphoedema as there are some inherent differences in aesthetic liposuction. Patients report improvements in quality of life and are required to wear compression garments for life in order to maintain the results of surgery.
