Woo, J.H., Park, H.S., Kim, S.C., & Kim, Y.H. (2013). The effect of lumbar sympathetic ganglion block on gynecologic cancer–related lymphedema. Pain Physician, 16, 345–352.
To study treatment effect of lumbar sympathetic ganglion block (LSGB) on patients with lymphedema secondary to gynecologic cancer treatment who did not respond to conservative treatment, defined as complex decongestive physiotherapy or manual lymphatic drainage, compression therapy, exercise, and skin care.
Fluoroscopy-guided LSGB was performed on stage II lower limb lymphedema patients three times at two-week intervals. Thigh and calf measurements were measured upright at first visit and two weeks post-LSGB.
Thigh and calf circumference reductions were greatest after the third LSGB and totaled 4 cm in thigh and 2 cm in calf. Pain score was also reduced.
This was a very small study measuring an intervention with radiation exposure, and procedure risks appeared to outweigh benefit. No long-term follow-up was noted. The study lacked researcher reliability and validity, with no noted description of thigh and calf measurement tools.
Careful consideration of risk to benefit ratio for patients undergoing LSGB is recommended because this procedure should only be performed under the auspices of research. High-quality controlled research studies with long-term follow-up are needed.