Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Pusan, 626-770, Republic of Korea.
The aims of this study were to investigate the long-term effect of complex decongestive therapy (CDT) onlymphedema volume reduction, especially considering the proximal and distal parts of the leg, and to evaluate the utility of pre-therapy lymphoscintigraphy in predicting the response to CDT in patients with lower-limb lymphedema after surgery for gynecologic cancer.
Medical records of 158 patients with secondary lymphedema of unilateral leg after surgery for gynecological cancer were reviewed retrospectively. They were treated with two weeks of CDT along with self-administered home therapy and were followed up for 24months. Whole, proximal and distal leg volume was serially measured by using an optoelectric volumeter prior to and immediately after therapy, and follow-up visits at months 3, 6, 12 and 24. Lymphoscintigraphy was performed prior to therapy.
The percent volume reduction was 22.1% in the whole leg, 30.9% in the distal leg and 18.4% in the proximal legimmediately after CDT. The volume reduction was maintained for 24months, but the distal leg was significantly well maintained better than the proximal leg. Extremity radioisotope uptake ratio (EUR) among lymphoscintigraphic findings could predict the improvement of lymphedema volume in the distal, proximal and whole leg.
CONCLUSION:This study suggests that the long-term edema reducing effects of CDT are better maintained in the distalleg than in the proximal part, and initial lymphoscintigraphic quantitative finding may usefully predict the short and long-term response to CDT.