9809-1058 Brorson
Brorson H, Svensson H.
Liposuction combined with controlled compression therapy reduces arm lymphedema
more effectively than controlled compression therapy alone.
Plast Reconstr Surg. 1998 Sep;102(4):1058-67; discussion 1068. PMID: 9734424
Department of Plastic and Reconstructive Surgery, Malmo University Hospital,
Sweden.
Arm lymphedema after breast cancer therapy has been treated with various forms
of conservative and surgical treatment during recent years. The clinical results
usually have been modest or, in some instances, even disappointing. In a
previous series of patients treated with the new liposuction technique combined
with controlled compression therapy, we found, however, an overall edema
reduction of 106 percent after 1 year. The purpose of this study was both to
investigate how much the surgical procedure contributes to the outcome and to
clarify the importance of controlled compression therapy. Twenty-eight patients
were, therefore, prospectively matched into two groups. One group received
liposuction combined with controlled compression therapy, and one group received
the therapy alone. Additionally, the therapy group was compared with our
complete group of patients treated thus far with liposuction combined with
therapy (n = 30). The prospective study using matched pairs (n = 14) showed that
liposuction combined with controlled compression therapy is significantly more
effective than the therapy alone (p < 0.0001), with a mean difference of about
1000 ml during the entire 1-year observation period. The beneficial effect of
liposuction was confirmed by the comparison between the controlled compression
therapy group and our complete group of patients treated with liposuction
combined with the therapy, as the edema reduction figures after 1 year were 47
percent and 104 percent, respectively (p < 0.0001). In six patients who had
surgery and a complete reduction of the edema, the compression garments were
removed for 1 week, 1 year postoperatively. A marked increase in the arm volume
was observed, which was immediately remedied by reapplying the garments. We
conclude that liposuction combined with controlled compression therapy reduces
arm lymphedema more efficiently than the therapy alone. Continued use of
compression garments is, however, important to maintain the primary surgical
outcome.
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