Lymphedema: A Difficult "Marathon," A Warm Embrace of Care

Lymphedema is a chronic, progressive disease caused by obstruction of lymphatic circulation. Its causes are complex, including congenital lymphatic malformations and secondary damage from surgery, radiotherapy, and other treatments.

Lymphedema is particularly common in patients who have undergone radical mastectomy or pelvic tumor resection with lymph node dissection. Once the lymphatic system is damaged, lymph fluid cannot drain properly and gradually accumulates in the interstitial spaces, causing limb swelling, a feeling of heaviness, pain, and even recurrent infections.

For patients, this is an unending journey, a dual torment of body and mind.

02Ms. Zhang: An Unyielding Fight Against Lymphedema

Ms. Zhang (pseudonym), 56 years old, from Loudi, Hunan Province. An outgoing and hardworking woman, she thought she could slow down and enjoy life, but was diagnosed with endometrial cancer during a routine checkup. After undergoing a total hysterectomy with bilateral salpingo-oophorectomy, pelvic lymph node dissection, and postoperative chemotherapy, she successfully navigated the critical phase of cancer treatment.

However, shortly after surgery, progressively worsening swelling in both lower limbs began to plague her relentlessly. Initially, it was occasional swelling and a feeling of heaviness, which gradually developed into persistent edema, rough skin, and reduced mobility. Daily walking became difficult, and going out became a burden. After about six months of progression, her lymphedema had reached the second stage, the “subclinical stage,” where the swelling is not fully reversible, and the skin begins to thicken and harden.

The immense physical and mental pressure was overwhelming, and the worsening edema and mobility impairment gradually eroded her confidence in life. In this helpless state, Ms. Zhang chose to seek help again from Director Zhu Xiongxiang of the HeYou Hospital Plastic Surgery Department.

03Clearing the “Blockage” with Supermicrosurgery

After a detailed assessment of Ms. Zhang’s condition, Director Zhu Xiongxiang formulated a precise surgical plan:

LVA (Lymphaticovenular Anastomosis). Utilizing supermicrosurgery techniques and indocyanine green lymphography, a new “drainage channel” was reconstructed for her right lower limb.

The principle of LVA surgery is to directly anastomose functional lymphatic vessels with adjacent small veins using microsurgical techniques, creating a new outlet for the “blocked” lymph fluid and re-establishing a drainage pathway.

The surgical team completed precise anastomoses of over 20 groups of lymphatic vessels and veins at 7 sites on Ms. Zhang’s right leg.

The postoperative recovery process was encouraging. At the first dressing change, the swelling in Ms. Zhang’s right leg had already significantly decreased, and skin folds began to appear, indicating the gradual absorption of edema fluid.

At the two-month postoperative follow-up, the data showed:

Right ankle circumference: Pre-op 25.3cm → Post-op 23.0cm (decrease of approx. 3.2cm)

Right mid-calf circumference: Pre-op 39.0cm → Post-op 33.0cm (decrease of approx. 6cm)

When walking, she felt her legs were much lighter, and her movement became more agile.

04Team Collaboration: Building a Precise and Efficient Treatment Platform

Ms. Zhang’s recovery is the result of the collaborative efforts of the Plastic Surgery team at HeYou Hospital. 

The department is led by Director Zhu Xiongxiang, a nationally renowned microsurgery expert, and possesses internationally advanced supermicrosurgery techniques capable of operating on blood vessels and lymphatic vessels as small as 0.1mm. Additionally, it is equipped with a high-end lymphography system (ICG fluorescence imaging) for precise intraoperative localization of lymphatic flow, enhancing surgical safety and success rates.

The team works seamlessly during surgery and follows a rigorous postoperative rehabilitation protocol, ensuring that every step from preoperative assessment and surgical execution to postoperative care is precise and meticulous.

Specialized nursing staff possess extensive experience in lymphedema care, guiding patients in the correct use of compression bandages, functional exercises, and skin care, effectively helping to consolidate treatment outcomes and promote recovery.

05Lymphedema Specialty Clinic: Safeguarding Hope with Expertise

To better serve patients, the Plastic Surgery Department at HeYou Hospital has established a Lymphedema Specialty Clinic, systematically offering a full range of services from early assessment and conservative treatment to microsurgery and rehabilitation management. The team creates a comprehensive file for each patient and develops an individualized long-term management plan.

The nursing team also takes on the responsibility of patient education and psychological support, helping patients face their illness and regain confidence. The treatment window for lymphedema is critical.

Early detection and early intervention can significantly slow disease progression, alleviate symptoms, and improve quality of life.

The application of emerging imaging technologies such as ultrasound and lymphography also allows us to identify problems and accurately determine indications at an earlier stage, thereby seizing the optimal opportunity for treatment.

We call upon all sectors of society to pay attention to the physical and mental health of lymphedema patients, helping more people understand the disease, dispel misconceptions, and seek timely medical attention, so they can bid farewell to pain and return to the essence and lightness of life as soon as possible.

For every patient, recovery is not just a physical improvement but a restoration of dignity and quality of life.

The journey of lymphedema treatment may be long, but it is by no means hopeless. We are committed to using our professional skills and humanistic care to accompany them through hardship and difficulty, guiding them back towards sunshine and hope.

Pay attention to lymphedema, starting with understanding and companionship. Let us work together to light the way forward for more patients.

Author>>> Plastic Surgery |  Zhang Yingjie, Li Wenbo

Medical Guidance>>> Plastic Surgery |  Zhu Xiongxiang (Chief Physician)

(As individual patient conditions vary, treatment outcomes may differ. Please consult a professional physician for specific advice.)