High-frequency ultrasound imaging of subcutaneous lymphatic and venular vessels in the planning of lymphatic drainage surgeries

Upper limb lymphedema following axillary lymph node dissection for breast cancer is one of the most common postoperative complications, significantly reducing patients’ quality of life. This clinical case demonstrates the effectiveness of lymphovenular anastomosis (LVA) as a method that allows for the correction of pathological processes associated with obstructive lymphedema at the early and intermediate stages of the disease. The importance of preoperative assessment and mapping of lymphatic and venous vessels using ultrasound technologies is emphasized, as it enables optimization of surgical tactics, improves the procedure’s efficiency, and reduces operative time. The article discusses the pathophysiological features of lymphedema, including vascular sclerosis and decreased lymphatic drainage capacity, as well as the advantages of modern instrumental diagnostic methods in planning LVA. Attention is drawn to the necessity of an individualized approach to each patient, based on thorough preoperative evaluation of the vascular network, as well as the importance of ultrasound monitoring in the postoperative period for controlling the condition of lymphedema.

Thus, the decisive role of a comprehensive strategy – including preliminary diagnostics and meticulous surgical planning – ensures the most effective clinical outcomes in the treatment of upper limb lymphedema using the LVA method.

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