Abstract
The number of patients with secondary lymphedema will likely increase as the population ages. For elderly patients, it is difficult to put on elastic stockings for reasons such as muscular weakness. We present two secondary lymphedema patients who underwent lymphaticovenular anastomosis (LVA) prior to physical therapy. The results of preoperative lymph scintigraphy for both patients indicated that the contraction of the lymph smooth muscles remained. After successful LVA, the patients could wear elastic stockings. Recently, LVA is becoming popular for the treatment of lymphedema. However, complex physical therapies, such as lymph drainage, wearing elastic sleeves or stockings, and multilayered compression bandages, are considered to be the primary course of treatment, and elderly patients have difficulty managing their condition by themselves. To maintain lymphatic flow after LVA, contraction of the smooth muscles plays a crucial role. Therefore, evaluation of the remaining function of the lymph vessels is important to determine if LVA should be recommended. These cases suggest that LVA should be considered before complex physical therapy for elderly patients.
