The inguinal area has much larger lymph nodes than the armpitarmpit armpit. Anyway, not all inguinal lymph nodes are part of the leg drainage system. The superficial group is a reserve and normally acts to drain lymph from the lower abdomen. So, if it’s being grafted no leg lymphedema would appear. That’s why the surgeon must identify correctly those superficial nodes. Fluorescent lymphography and US scans are useful tools to find the right lymph nodes. A special agent – green indocyanine – is injected subcutaneously into the foot before the surgical procedure. It spreads via lymphatic pathways and eventually gets into superficial inguinal nodes. That helps a surgeon to precisely dissect nodes needed to be transplanted. This approach minimizes the risk of lymphatic complications.
In the case of using cervical and mental (from the chin), there are no risks of lymphedema due to extensive lymph net. A few removed nodes won’t affect the drainage.
Remember, if the procedure is not performed anywhere in Russia, it must be unsafe.
Node transplantation requires special equipment: an operative microscope, lymphography set, microsurgery tools, and some others that most Russian clinics consider unnecessary. What’s more, it requires highly trained personnel and a modality of working with the lymphatic system. This kind of school is not yet formed in our country, it’s yet to come. So, with all regard to Russian medicine and surgical tradition, it should not be the best reference there is. Those who speculate on European research that hasn’t proved efficiency or such procedures are either not being honest or can’t read English.
Lymphostasis: risk factors
What oncological and surgical factors may increase the risk of swelling?
Tumor size.
Patients with T1 have a 3.92 lower risk of lymphedema than those with T3
Metastases in axillar (armpit) lymph nodes increase the risk of lymphedema 2.12 timesymph nodes increase the risk of lymphostasis 2.12 times.
Number of lymph nodes removed.
If more than 5 lymph nodes were removed the risk is 3.52 higher.
Adjuvant chemotherapy increases the risk of swelling 3 times.
Higher BMI makes 3.24 times increase of the risk of swelling.
Post-op radiotherapy increases the risk of lymphedema 7 times!
Interestingly, patients with higher levels of education have lesser risks of lymphedema. This might be due to their conscious attitude to hygiene and daily regimen.
All the data above were obtained from Iowa Woman’s Health Study where there were 1200 female participants treated for breast cancer.
How to lower the risk of lymphedema?
- Take care of your own health and go through checkup as it is recommended. By this it is possible to detect tumor on early stages and to avoid aggressive surgery or radiotherapy.
- Weight control.
- If the tumor is found, a clinic with facilities to perform sentinel node biopsy should be preferred.
If you have undergone a surgical procedure and found two or more lymphedema risk factors – please have a medical check with fluorescent lymphography to prevent deterioration in the early stages when treatment can be mild and more comfortable.