Lymphographic investigations of oedema of the extremities following reconstructive vascular surgery in the femoro-popliteal territory

Schmidt, K.R.; Welter, H.; Pfeifer, K.J.; Becker, H.M.

Rofo Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 128(2): 194-202


ISSN/ISBN: 1438-9029
PMID: 147218
DOI: 10.1055/s-0029-1230824
Accession: 068522157

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In 37 patients, oedema of the legs was observed following successful femoro-popliteal surgery; lymphangiograms were performed between the third and ninth post-operative days and the intact lymph vessels at the knee and at the groin were counted. In 27 patients there was partial to total disruption of the lymphatic vessels. There was a clear correlation between the degree of swelling of the leg and thigh with the number of not divided lymphatic vessels at the knee and groin. In the presence of more than three intact lymph vessels, swelling amounted to only 1 to 2 cm., whereas if all lymph vessels had been divided, swelling amounted to 7 cm. Extensive soft tissue trauma and repeat surgery resulted in a greater reduction in intact lymph vessels and correspondingly more oedema than was found with more conservative surgery and after initial operations. The pre-operative condition of the arteries, the presence of venous disease and the postoperative blood-flow in the leg had no influence on postoperative oedema. In order to avoid post-operative lymphoedema, it is necessary to preserve the lymphatics during surgery. Marked oedema requires treatment consisting of compression bandages and medicaments.