Surgical Treatment Options in Lymphology

The lymphatic system is essential for the transport of interstitial fluid back into the vascular system. Disturbance of the complex network can lead to edema and the accumulation of proteins and lipids in the affected body region. Even though the lymphatic system has been a topic of intense research for centuries, lymphological diseases like lymphedema as a possible secondary effect of oncological treatment only recently gained attention. Secondary lymphedema can have traumatic, infectious or iatrogenic causes and mainly affects women with an incidence of 0.13-2%. The lipedema is another disease with increasing public interest in recent years but should be differentiated from lymphedema. Both diseases can involve painful circumferential growth, limitations in the professional and private daily routine and lead to a reduced quality of life. Beside clinical examination new imaging techniques are of increasing importance for the diagnostic procedure, the staging and the planning of treatments. However, in many cases it takes months or even years until the correct diagnosis is found. While therapy is still based on conservative treatment options like the complex manual decongestion therapy, surgical treatment options are increasingly used for patients with lymphedema. Reducing surgical methods are mainly leading to a decrease of symptoms whereas reconstructive surgical techniques aim to reconstruct the lymphatic system using microsurgery. In the following, various surgical therapy options in lymphology are presented.