Lymphedema is a kind of diseases regarding as incurable disease despite of medical progress. Secondary lymphedema is a condition characterized by swelling of the soft tissues in which an excessive amount of lymph has accumulated, and can result from irradiation or the removal of lymph nodes during various cancer surgeries, especially for uterine and breast cancers. The improvement of swelling can be achieved by comprehensive non-operative compression therapy and manual lymph drainage, treatment of this condition requires lifelong care and good compliance.
We can apply the operative therapeutic methods, such as debulking, microsurgical lymph node transfer or lymph-venous shunt operation, and liposuction.
Among these treatments we adapted liposuction. Liposuction is an operation during which a tube is inserted under the skin. Through this tube, a high negative pressure vacuum is applied to break up and "suck out" excess fat cells. This procedure often leaves excess skin hanging loose. This specialized procedure can become necessary in lymphedema because of the tendency for fatty overgrowth in chronic lymphedema. (Stanford) And we applied the graft of stromal vascular factor (SVF) which has property of angiogenesis and lymphangiogesis.
This case which we present is 48 year old female patient with lymphedema on left lower extremity. She had received total hysterectomy due to uterine cancer with lymphadenectomy. And she did not received radiation therapy or chemotherapy after operation. Lymphedema was developed 5 years ago. Compression therapy by wearing medical compression stockings and wrapping by low elastic bandage was applied, however the swelling was aggravated and skin was hardened day by day without effects. We did liposuction, lympho-drainage.