Lin, a 49-year-old woman, suffered from cervical cancer in 2003 and underwent total hysterectomy, salpingectomy and lymph node dissection. After the operation, she received radiotherapy. Six months after radiotherapy, lymphedema began to appear in her right lower limb. Due to work factors, standing for a long time, the right lower limb is prone to swelling, pain and discomfort, and it is impossible to wear ordinary pants and shoes, which seriously affects daily life. She was also infected with cellulitis three times. The patient was later transferred to Linkou Chang Gung Hospital, and the problem of lymphedema of upper and lower limbs after cancer resection was relieved by microvascular surgery.

Linkou Chang Gung Hospital published microvascular surgery for lymphedema of upper and lower limbs after radiotherapy. (Photo courtesy/Linkou Chang Gung Hospital) Huang Mi, a doctor from the Department of Plastic Surgery, Linkou Chang Gung Hospital, said that the so-called postoperative lymphedema of breast cancer or cervical cancer refers to the tissue fibrosis caused by surgical lymph node resection or radiotherapy, which leads to problems in the lymphatic reflux channel, and lymph cannot return to the blood circulation through the lymphatic system, resulting in abnormal accumulation of high-protein tissue fluid, causing edema of upper limbs or lower limbs. According to empirical research, resection of more than 20 lymph nodes combined with radiotherapy will increase the probability of lymphedema.

Physiological effects of lymphedema of upper limbs or lower limbs include swelling, pain and dryness of affected limbs or body parts. Patients will feel heavy swelling, tight and numb skin, limited limb movement, tissue fibrosis, easy infection, and even affect the ability of wound healing. Psychologically, patients will have depression and negative self-feeling due to the change of body image or physical discomfort, which will lead to the reduction of social activities and leisure activities and affect the quality of life.

After lymph node dissection and radiotherapy, patients with breast cancer and cervical cancer are prone to edema of upper limbs or lower limbs due to the destruction of lymph nodes, just like floods. Transplanted lymph nodes are like water pump motors, which can pump lymph from flooded areas into the blood system and improve edema of lower limbs. After receiving this innovative operation, Ms. Lin said happily that the long-standing problem of lymphedema of the right lower limb has indeed improved after the operation.

This innovative operation was published in the authoritative international journal of plastic surgery "Plastic Reconstruction Surgery" in April 2009. The theme is "vascularized granular lymph node metastasis using write as the recipient site for the management of lymphedema of upper limbs after mastectomy".