Authors (including presenting author) :
Chun OK(1), Leung WC(2), Wong WL(1), Ng E(2), Siu CS(1), Yeung A(2), Ng YH(1), Yau WM(1), Tse DA(1)
Affiliation :
(1) Department of Surgery, Kwong Wah Hospital, (2) Physiotherapy Department, Kwong Wah Hospital
Keyword 1: :
lymphovenous anastomosis
Keyword 3: :
complex lymphoedema therapy
Keyword 4: :
quality of life
Introduction :
The lymphatic system helps to regulate the balance of fluid. When the lymphatic system does not work properly, lymph fluid accumulates and unable to return to the bloodstream causing secondary lymphoedema. Lymphoedema is a chronic condition and has negative impacts on patients’ quality of life due to the associated limb swelling, aching, restricted range of motion and higher risk of infection. It may also cause psychological problems and social problems. Many patients are managed by conservative non-invasive method named complex lymphoedema therapy (CLT). CLT includes patient education on risk reduction, skin care and scar management, decongestive exercise, lymphatic massage and compression. Generally, patients require numerous adaptations on their daily life.
Objectives :
To enhance the quality of care of lymphoedema patients.
Methodology :
We know CLT is not a curative approach and many studies have shown a positive effect of LVA that directly links the obstructed lymphatic vessels to nearby veins. KWH would like to offer this surgery to our patients. Multidisciplinary team is formed including Plastic Surgeons, Breast Care Nurses, Plastic Nurses and Physiotherapists and a preparatory meeting is conducted. The direction of our service is confirmed and local protocol including patient selection criteria, pre-operative assessment, post-operative care, follow up plan, service model and workflow, different levels of exercise, application of bandaging, assessment tools for the outcome measures and patient education materials is drafted based on international guidelines and recent literatures. In June 2025, the service was launched out in our hospital.
Result & Outcome :
Best practice management for lymphoedema is via a holistic, multidisciplinary team approach and is provided by qualified lymphoedma therapists. The development of this new service in KWH allows our patients to have one more treatment modality. Properly selected lymphoedema patients may benefit from LVA surgery in terms of optimizing the physical symptoms, improving quality of life and reduction of complications such as cellulitis. In the coming future, we would like to evaluate the efficacy and safety of LVA, patients’ experience and outcomes after LVA and share our experience on caring those patients.
