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Surgical treatment of primary and secondary lymphedema

Babak Mehrara, MD
Section Editors
Russell S Berman, MD
Charles E Butler, MD, FACS
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


Operative management of primary and secondary lymphedema is typically reserved for localized primary malformations, failed medical management, or recurrent cellulitis in affected extremities. There is no consensus regarding the role of surgery, the optimal surgical approach, or the timing of an operative procedure for extremity lymphedema.

The indications, preoperative evaluation, and operative management of primary and secondary lymphedema will be reviewed here. Other characteristics of lymphedema, including etiology, diagnosis, and clinical manifestations, are discussed elsewhere. (See "Clinical features and diagnosis of peripheral lymphedema" and "Clinical staging and conservative management of peripheral lymphedema" and "Pathophysiology and etiology of edema in children" and "Clinical manifestations and diagnosis of edema in adults".)


Nonoperative measures, including compressive garments and decongestive therapy, are the initial approach for management of lymphedema, as discussed elsewhere. (See "Clinical staging and conservative management of peripheral lymphedema", section on 'Overview of management'.)

The indications for operative management of primary and secondary lymphedema include [1-6]:

Localized primary lesions (including microcystic and macroscopic lymphatic malformations)

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Literature review current through: Nov 2017. | This topic last updated: Mar 16, 2017.
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