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Abstract
Introduction/Background Secondary lower limb lymphedema (LLL) is a frequently reported complication in women with gynecological cancer surgery, which can have serious physical and psychological consequences. Although complex decongestive physical therapy(CDT) is widely used, the optimal treatment is still unknown. Lumbar sympathetic ganglion block (LSGB) is a treatment involving injecting a drug mixture around the sympathetic trunk. Few studies focus on the use of LSGB for limb lymphedema. Hence, we aimed to investigate the clinical effect of LSGB in gynecological cancer patients with secondary LLL and to explore its impact on life quality.
Methodology We included 94 gynecological cancer survivors with stage two LLL who received either CDT or CDT combined with LSGB treatment between September 2021 and September 2023 in our hospital. Fluoroscopy-guided LSGB, two times at 3-day intervals, was extra performed in CDT+LSGB groups. Clinical data was retrospectively analyzed. Circumferences of five leg points, including thigh 1, thigh 2, calf, ankle, and foot, were assessed on the first day and one week after treatment. The Lymphedema Quality of Life Questionnaire-LEG (LYMQOL-LEG) was monitored before and after treatment.
Results There were 36 patients in the CDT group and 58 in the CDT+LSGB group. The leg circumferences of thigh 1, thigh 2, and calf decreased more in the CDT+LSGB group than in CDT groups (P thigh 1 =0.028; P thigh 2 =0.017; and P calf= 0.019;). Although the circumferences of ankle and foot showed no difference in the two groups(P ankle= 0.240; P foot = 0.307), the total length of five regressions in the CDT+LSGB group was still better than that of CDT groups (P =0.030). On the other hand, the life quality improved more in patients with CDT+LSGB treatment compared with CDT treatment alone (P <0.05).
Conclusion LSGB can be a safe and effective treatment option for gynecological cancer survivors with secondary LLL.
Disclosures This work was sponsored by the Joint Funds for the Innovation of Science and Technology, Fujian Province (Grant number 2021Y9209) and the Fujian Provincial Health Technology Project (Grant number 2021QNA043). The authors declare no competing financial interests.
Patient selection
The measurement points
Fluoroscopic image SLGB
Outcomes of CDT+LSGB A Before; B After
The regression of LLL during treatment.