Secondary lymphedema as a part of post-mastectomy syndrome after complex treatment of breast cancer is a common problem. Conservative approaches (complex physical decongestant therapy) were the only option for these patients for a long time. Development of microsurgical technologies, new surgical techniques and modern methods of diagnosis and visualization of lymphatic system expanded the capabilities of reconstructive surgeons for these patients. Such methods as lympho-venous bypass and lymph nodes transplantation demonstrate encouraging results in patients with mild and severe lymphedema. Inclusion of lymphoid tissue into microsurgical flaps for breast reconstruction makes it possible to restore the lost organ and correct lymphedema within the same surgery. Improvement of resection techniques and their combination with complex decongestant therapy make it possible to expand the indications for patients with different stages of disease. In this article, the authors discuss modern approaches to treatment of lymphedema, features and options of surgical treatment, diagnosis and staging in accordance with international classifications.

Keywords. lymphedema, post-mastectomy syndrome, lymph node dissection, microsurgery, free flap