Wang HJ, He QQ, Liu CR, Wang YY, Liu XW. Lymphovenous anastomosis and complex decongestive therapy for severe deformed lymphedema with recurrent infection: A case report. World J Clin Cases 2024; 12(22): 5159-5167 [DOI: 10.12998/wjcc.v12.i22.5159]
Corresponding Author of This Article
Qing-Qing He, MD, Professor, Surgical Oncologist, Department of Thyroid and Breast Surgery, The 960th Hospital of People’s Liberation Army, No. 25 Shifan Road, Jinan 250000, Shandong Province, China. heqingqing@yeah.net
Research Domain of This Article
Gerontology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 6, 2024; 12(22): 5159-5167 Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.5159
Lymphovenous anastomosis and complex decongestive therapy for severe deformed lymphedema with recurrent infection: A case report
He-Jun Wang, Qing-Qing He, Chang-Rui Liu, Ying-Ying Wang, Xun-Wei Liu
He-Jun Wang, Qing-Qing He, Chang-Rui Liu, Ying-Ying Wang, Department of Thyroid and Breast Surgery, The 960th Hospital of People’s Liberation Army, Jinan 250000, Shandong Province, China
Xun-Wei Liu, Department of Oncology, The 960th Hospital of People’s Liberation Army, Jinan 250000, Shandong Province, China
Author contributions: Wang HJ, He QQ and Liu CR designed the research study; Wang HJ, Wang YY performed the research; Wang HJ, Liu XW wrote the manuscript. All authors have read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing-Qing He, MD, Professor, Surgical Oncologist, Department of Thyroid and Breast Surgery, The 960th Hospital of People’s Liberation Army, No. 25 Shifan Road, Jinan 250000, Shandong Province, China. heqingqing@yeah.net
Received: March 5, 2024 Revised: May 30, 2024 Accepted: June 18, 2024 Published online: August 6, 2024 Processing time: 118 Days and 14.1 Hours
Abstract
BACKGROUND
Lower extremity lymphedema is a common complication following treatment for gynecological malignancies. Its incidence rate can reach up to 70%, affecting ~20 million people worldwide. However, specialized treatment centers are scarce, and there is a lack of consensus on treatment approaches. Furthermore, there are even fewer reports on the systematic and effective treatment of severe lymphedema with malformations. Effective management of this condition remains a significant challenge for clinicians.
CASE SUMMARY
A 40-year-old woman developed bilateral leg swelling 6 years after receiving treatment for endometrial cancer. Since August 2018, she experienced > 30 episodes of lymphangitis. Upon presentation, she exhibited bilateral leg swelling and deformation, with four large swellings in the posterior thigh that impeded movement, and pain in the limbs. Skin manifestations included lichenoid lesions and features of deep sclerosis. Radionuclide lymphoscintigraphy confirmed the diagnosis of lower limb lymphedema. After 6 mo of complex decongestive therapy (CDT) and three lymphaticovenous anastomosis (LVA) treatments, the patient lost 49 kg in weight. She also experienced a maximum circumference reduction of 35.2 cm in the left lower limb and 37.5 cm in the right lower limb. The leg pain disappeared, her swelling significantly decreased, and she regained the ability to walk, cycle, and run normally.
CONCLUSION
The combined application of CDT and LVA therapy demonstrates significant positive effects in the treatment of severe, deformed stage III lymphedema.
Core Tip: We report a 40-year-old woman who developed severe lower extremity lymphedema following treatment for endometrial cancer. She underwent a combination of complex decongestive therapy (CDT) and lymphaticovenous anastomosis (LVA). This significantly improved lower limb motor function, with the near-complete resolution of discomfort and a substantial return to normal limb appearance. This case suggests that combined application of CDT and LVA offers a promising therapeutic approach for severe, deformed lymphedema. This minimally invasive strategy, with its associated benefits of minimal surgical trauma and good postoperative aesthetics, has the potential to equip future clinicians with improved management strategies for severely deformed lower extremity lymphedema.
