Liposuction for chronic lymphoedema of the upper limb: 5 Years of experience

Background: Lymphoedema of the upper limb is a well-recognised complication of axillary surgery for breast cancer. Effective long-term treatment of lymphoedema by liposuction has previously been demonstrated. In this study we present our first five years of experience using this technique in treatment of upper limb lymphoedema. Methods: A prospective analysis of the results of 12 patients who underwent liposuction followed by compression therapy for chronic unilateral upper limb oedema with up to five years of follow-up was carried out. Hospital Anxiety and Depression Score questionnaires and a Visual Analogue Score for overall well-being were also completed pre- and post-operatively. Results: The mean duration of lymphoedema was seven years (range, 1-14), commencing at a mean of one year (range, 0-5) after axillary surgery. The mean excess arm volume at admission was 1391 ml and the ratio of the lymphoedematous to the unaffected arm was 1·48. The mean total aspirate volume was 1713 ml, of which 87 percent was fat. At one year the mean percentage volume reduction compared with the normal arm was 101 percent, meaning that the volume of both of patients' arms was virtually equivalent, and this reduction was stable with up to 5 years of follow-up. Postoperatively there were reductions in anxiety (p < 0.05) and depression scores, and an improvement in overall well-being. Discussion: Our first five years of experience of liposuction combined with application of compression garments has demonstrated significant, reproducible, and stable reduction of upper limb oedema with improvement of overall well-being and reduction in measurable anxiety and depression.