Surgical treatment of lymphostasis. Literature review

Introduction. Secondary lymphostasis (lymphedema) is a consequence of impaired lymphatic drainage from the limb due to various causes. An increase in the incidence of breast cancer leads to an increase in severe lymphostasis requiring surgical correction. Erysipelas is traditionally distinguished among the causes of lymphostasis of the lower extremities, causing persistent lymphedema that does not respond to conservative therapy, as well as malignant diseases of the genital area in men. The increase in patients with lymphedema requiring surgical correction necessitates the search for new ways to restore patency of the lymphatic pathways. Materials and methods. The search for literary sources was carried out in the PubMed and eLibrary databases. The main part. New protocols for X-ray contrast studies with the search for new areas of lymph insertion and drainage are proposed. One of the most effective methods is fluorescence lymphography. Ultrasound is widely used to determine the condition of lymph nodes. The article discusses various methods of applying lymphovenous anastomoses, advantages and disadvantages, and the number of shunts applied. The issues of preventive lymphovenous bypass surgery and lymph node transplantation are discussed. Conclusion. Lymphovenous anastomosis is the method of choice in the treatment of lymphedema. With the functioning of the shunt, patients note a subjective improvement, a significant decrease in the volume of the limb. Most studies confirm the effectiveness of this method in the long term. The issues of preventive lymphovenous anastomosis and lymph node transplantation require further consideration.