Surgical treatment in children with lymphoedema
The evaluation of the lymphoedema of the children is clinical, genetic and can be identified with lymphoMRI.
A big hand can have different origins
The hypoplasic cases
The hypoplasic cases can be treated by the autologous lymphnodes transfers , combined, in some times , with local resections and local liposculptures and resection of fibrotic scars.
If the children are under 12 months, the fibrosis is less important and the results after ALNT can be extremely rewarding: normalization in most of the cases.
Regarding those results, it is very important to operate the children as soon as possible, even if the vessels are thiny, before the fibrosis.When they are older, it is so much complicated and 2 flaps plus liposculpture are mandatory,
The abdominal and general syndrome must be completely evaluated. Systemic treatement (cyrolymus), parenteral alimentation,resection of the cysts, lymphovenous anastomosis and in some cases, lymphnodes transfers can be performed, but step by step. Soon, a direct genetic manipulation will be perhaps the solution (de Duve foundation).For the parents, keep informed!