The role of microsurgery in the combined treatment of peripheral lymphedema

The Authors report the modem surgical management of peripheral lymphedema. An adequate diagnostic route is essential. It has to include patient history and clinical examination, an isotopic lymphography, an accurate study of the venous circulation and, in case of angiodysplasia, of the artery circulation. Based on Authors' over 25 years clinical experience (over 1000 patients, of whom 843 controlled at over 5 till 15 years), the role of derivative and, in case of associated venous diseases, of reconstructive lymphatic microsurgery is particularly underlined, in comparison with the conservative medico-physical treatment, to which is complementary. The "debulking" surgery can be used just in properly selected patients for minor operations with only cosmethic-reductive purposes. Positive results from lymphatic microsurgery can be achieved in more than 80% of cases, especially in patients at precocious stages.