REHABILITATION AFTER LOWER LIMB LYMPHOEDEMA IN GYNAECOLOGICAL MALIGNANCIES – THE ROLE OF PHYSIOTHERAPY

Abstract

Lower limb lymphoedema is one of the most invalidating long-term complications of treatments (such as surgery, chemo- and radiotherapy) for gynaecological malignancies, affecting approximately 15% of women treated for this condition. Lower limb lymphoedema occurrence is related to several risk factors, the most important being obesity and radiotherapy as well as the number of surgically removed lymph nodes. We conducted a retrospective study to assess the risk factors and efficiency of physiotherapy procedures in reducing lower limb lymphoedema in women who underwent an exhaustive treatment plan for gynaecological malignancies. The study enrolled 21 patients with lower limb lymphoedema, who were initially treated by a multidisciplinary team for gynaecological malignancies at the “Prof. Dr Alexandru Trestioreanu” Institute of Oncology in Bucharest. Early initiation of physiotherapy after surgical treatment and radiotherapy, along with patient education, is associated with a higher regression rate of lower limb lymphoedema compared to only patient education and awareness. The treatment response rate was better in patients benefitting from lymphatic drainage, compression bandage and an individual physiotherapy plan compared to patients who only received lymphatic drainage and compression bandage (Mann-Whitney U test, p = 0.05). Early detection and management of lower limb lymphoedema are important to prevent complications and improve quality of life for gynaecological cancer survivors.