Abstrakt
Presented work summarizes a pharmacotherapy of secondary lymphedema of the arm developing after axilla exenteration and/or radiotherapy. It points out the key etiopathogenesis sites of the "circulus vitiosus" of secondary lymphedema development and progression and shows a relation between pharmacological effects of benzopyrones,diuretics, systemically acting proteinases and lymphedema pathophysiology.
The authors conclude based on their own experience that the use of diuretics in the treatment of lymphedema is mostly contraindicated. Benzopyrones show mainly a supportive effect in physical therapy of lymphedema and their main indication is a dynamic insufficiency of lymphatic system at the venous system impairment.
Authors consider administration of systemically acting proteinases which have a direct causal relation to the lymphedema pathophysiology. Proteinase therapy of secondary lymphedema was successful in 70% of patients.