Lymphedema Treatment: Cost, Risks, Recovery

Overview

Lymphedema is a condition featured by painful swelling in arms or legs. The swelling is attributed to the lymph nodes which cannot facilitate the proper drainage of lymph fluid from an area of the body. Lymphedema may be caused by infection, trauma or treatment of cancer. It has symptoms such as change in skin quality, extremity tenderness or pain and excess fat in the extremity.

Once lymphedema is diagnosed, nonsurgical treatment is initiated as soon as possible, including:

  • Extremity elevation
  • Skin care
  • Elastic stockings
  • Physical therapy
  • Pneumatic compression devices

However, these treatments can be burdensome to patients and require lifelong commitment. When nonsurgical therapy is inadequate, surgery is needed. Surgical lymphedema treatment include:

  • Lymphatic Bypass Procedures, where lymphatic vessels are connected and drained into the body’s venous system
  • Vascularized Lymph Node Transfer, where lymph nodes are harvested from one part of the body and surgically implanted in the affected area

Candidates

A good candidate for lymphedema treatment include:

  • Able to cope with your diagnosis and treatment
  • Do not have additional medical conditions or other illnesses that may impair healing
  • Have a positive outlook and realistic expectations for restoring your extremity and body image
  • Have made the most of nonsurgical therapies for lymphedema

Cost

Lymphedema surgery costs are determined by:

  • Surgeon’s fee
  • Surgical facility costs
  • Anesthesia fees
  • Prescriptions for medication
  • Post-surgery garments
  • Medical tests and imaging

Lymphedema surgery after cancer treatment is considered as a reconstructive procedure. It should be covered by health insurance. However, your coverage only account for part of the total fee.

Risks

The risks associated with lymphedema surgery include:

  • Bleeding
  • Infection
  • Fluid collection
  • Poor healing of incisions
  • Anesthesia risks

Flap surgery (vascularized lymph node transfer) has the risk of partial or complete loss of the flap and a loss of sensation at both the donor and reconstruction site.

A rare complication of vascularized lymph node transfer is donor site lymphedema caused by damage to the donor site lymph nodes.

Preparation

Treatment plans are individualized according to the clinical stage of lymphedema and anatomical considerations.

During initial consultation, your surgeon may perform standardized and repeated measurements of limb circumference and refer you to specialized diagnostic testing.

Before the surgery, nonsurgical treatment must be made the most of including proper use of compression stockings, adherence to physical therapy recommendations, exercise and weight loss. Complete decongestive therapy (CDT) is critical in initial management for lymphedema patients.

Surgical steps

The following surgical options are available:

Lymphaticovenular anastomosis

Lymphaticovenular anastomosis (LVA) shunts excess lymphatic fluid into the venous circulation within the arm or leg. Small, superficial incisions are made on the limbs, and a surgical microscope is used to identify tiny lymphatic vessels beneath the skin. These lymphatic vessels can be connected to nearby small blood vessels. Lymphaticovenular connections are created as many as possible. This procedure is often performed on an outpatient basis.

Vascularized lymph node transfer

In situations when lymph node basins do not function, vascularized lymph node transfer (VLNT) can facilitate lymphatic drainage. Donor lymph nodes can be harvested from various locations such as the lower abdomen and neck. This procedure typically uses microsurgery techniques to transfer lymph nodes and fatty tissue with their blood supply. It typically requires hospitalization for several days.

Ablative procedures

Ablative procedures intend to remove excess skin and soft tissue to decrease bulk and facilitate hygiene. These operations are suitable for patients with advanced-stage lymphedema with significant fibrosis and fatty infiltration. Removing redundant skin with this technique may require more than one surgery. Patients must wear lifelong compression garments to maintain the effects of liposuction.

Anesthesia

During the surgical procedure, medications are administered for your comfort, such as intravenous sedation and general anesthesia.

Recovery

Healing will last for several weeks as swelling decreases. Gauze or bandages may be applied to your incisions. A small, thin tube may be temporarily placed under the skin to drain excess blood or fluid following flap procedures. You will receive specific instructions from your surgeon. Follow your surgeon’s advice and attend follow-up visits on time.

Keyword: lymphedema treatment.

Related posts:

Lymphedema: Types, Symptoms, Treatment

What Are the Basics of Lymphedema?

Is It Possible to Cure Lymphedema?

What Treatments May Lead to Lymphedema?

Can CDT Treat Lymphedema?

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.