Non-extremity lymphedema following axilla dissection and radiotherapy
Wald M. 1, Eliska O. 2, Krizova H. 3
1Department of Surgery, 2nd Faculty of Medicine, Prague 5, V uvalu 84, Czech Republic
2Department of
Anatomy, 1st Faculty of Medicine, Prague 2, U nemocnice 3, Czech
Republic
3Department of Nuclear Medicine, 2nd Faculty of Medicine, Prague 5, V uvalu 84, Czech
Republic
The European Journal
of Lymphology 2003, Vol. XI, Nr. 39, abst. VI-2, pp. 22
596 KA (20-01-3)
Purpose: The authors were focused on an occurrence, diagnostics, and therapy of non-extremity
lymphedema developing in association with axilla
dissection. Such lympedemas often remain unnoticed by the
physicians. They are most often located on chest, around scapula and in the epigastric region. Such located lymphedema may, similarly to the extremity lymphedema,
deteriorate quality of patient's life, including recurrent erysipelas.
Methods:
Detailed anamnesis and thorough clinical examination are basic presumptions of a
correct diagnosis.
Subsequent lymphoscintigraphy
of the region where a lymph drainage impairment is suspected both confirms a lymphedema
diagnosis and pictures alternative lymphatic routes which drain the
affected region. Knowledge of this drainage route is necessary for an effective
treatment.
Results and conclusion: 400 patients after axilla dissection and radiotherapy showing a lymphatic drainage impairment were examined. In 7% of patients, non-extremity lymphedema was diagnosed (scapula and epigastric region, chest). Combination of manual lymphodrainage, orally administered proteolytic enzymes, and corset was found the most effective therapy.