Lower-Extremity Lymphedema

Lower limb lymphedema can be devastating to the patients due to the added weight to the limbs, limited range of motion, deformity, and frequent cellulitis attacks. Supermicrosurgical lymphaticovenous anastomosis (LVA) was once considered unsuitable for treating severe lymphedema. However, with the addition of new clinical evidence and knowledge, this old concept has been transformed. In addition, new findings about the reduction of limb volume and muscle edema after LVA in both the affected and non-affected lower limb, in correlation with oxidative stress, have led to a new concept that a localized lower limb lymphedema may have systemic deleterious effects. With proper anastomotic configurations and meticulous anastomosis, a satisfactory outcome can be achieved.