Centers & Services

Lymphedema Treatment Team

Team overview

What is lymphedema?

Lymphedema is classified into primary of unknown cause and secondary of known cause.

Primary Congenital:Edema is present from birth, or occurs by two years of age. Poor lymphatic vessel formation engenders edema.
Early onset:Edema occurs before 35 years of age. Typically observed in women at menarche or during pregnancy.
Late onset:Edema occurs at not less than 35 years of age. It is presumably related to the hypofunction of the lymphatic vessels.
10% of lymphedema
Secondary Lymphedema occurring mainly after lymphadenectomy or radiotherapy for the treatment of cancer.
In other cases, it results from injury, filariasis, deterioration of varices, and deterioration of malignant tumors.
90% of lymphedema

Although it has been left untreated previously because "the life is saved," the symptom of lymphedema, i.e., edema of limbs, can strongly disturb daily life.
Once it occurs, lymphedema is extremely difficult to cure even now. The disease often gradually deteriorates when it is left untreated. Early diagnosis and early treatment are important because treatment will be very difficult once it deteriorates, with skin hardening and complications.
However, there still are only a small number of hospitals that comprehensively provide the standard therapy of lymphedema consisting of "complex physical therapy (conservative therapy)" and "surgical therapy (operative treatment.)"

Member departments

  • Plastic Surgery Department
  • Breast and Endocrine Surgery Department
  • Gynecology Department
  • Division of Physical Medicine and Rehabilitation

Members

  • Doctors
  • Medical lymph drainage therapist
  • Nurses
  • Physical therapists
  • Occupational therapists

Activities

  • Outpatient clinic specialized for lymphedema nursing care was opened in October 2010.
    We provide treatment in cooperation with patients considering physical, mental, and social circumstances.
  • We hold seminars in and out of the hospital to provide seamless care in cooperation with the community.
  • We and cooperating hospitals offer public seminars to medical workers and to patients for the education of lymphedema care.
  • We conduct clinical studies, striving toward better treatment every day.

Scope of treatment

At our hospital, the team of doctors, nurses, physical therapists and occupational therapists not only provides care for lymphedema after the treatment of malignant tumors, but also strives to enhance treatment of refractory cases such as congenital lymphedema and intractable lymphedema.
Patients from all over Japan from children to adults and elderly people have visited us for the improvement of symptoms.

Characteristics

  • Since 2000, our team have performed active treatment by the combination of conservative therapy and surgical therapy to lymphedema after accurate diagnosis of lymphedema.
  • Lymphedema Care Center was established at Kousei Hospital as a cooperating institution in 2008. We have held center meetings regularly to provide team medical care beyond the borders of hospitals.
  • We plan personalized treatment that is suitable for each patient. Nursing staff centering upon medical lymph drainage therapists participate in perioperative care so that the effects of surgery can be maximized when surgical therapy is used.
  • Care is provided in cooperation with related clinical departments.
  • Lymphedema care in the palliative period is provided.

Diagnosis of lymphedema

Edema of limbs is also caused by heart failure, renal failure and poor venous blood flow. Cases that are referred to us as lymphedema are often edema of other causes.
First, tests are performed which are necessary for clear diagnosis of the cause of edema. The subsequent treatment is performed safely. For the correct diagnosis of lymphedema, our hospital performs standardized fluorescence lymphography in all cases for the early detection and disease stage diagnosis of lymphedema.

Treatment of lymphedema


Fluorescence lymphography

For the treatment of lymphedema, we propose the best plan by all members of the team considering the state and the living environment of each patient in addition to the treatment method that can actually be continued.
Whereas sufficient effects can be achieved only by conservative therapy in some cases, we actively perform hybrid therapy combined with surgery for lymphedema.
Surgery for lymphedema is mainly surgery to improve the lymphatic flow, and surgical reduction of the volume, and a suitable method is selected depending on the state of lymphedema.
We mainly use lymphaticovenular anastomosis as lymph node transplantation as surgery to improve the lymphatic flow, and liposuction as surgical reduction. These methods are sometimes used in combination depending on situation.

Conservative therapy


Medical lymph drainage


Compression therapy by elastic garments and bandages

Surgical therapy

Surgical therapy results to date

Our hospital has actively performed surgical therapy for lymphedema since establishment of the team in 2000. Especially, we have treatment experience of more than 500 cases of lymphaticovenular anastomosis. A list of the number of cases of the last five years is presented below. Recently we have newly performed lymph node transplantation and liposuction, and so on, providing treatment in more than one technique.

  Lymphaticovenular anastomosis Lymph node transplantation Liposuction
2012 42    
2013 45 1 6
2014 46 7 14
2015 58 4 12
2016 50   14