2.3.3 Surgical Interventions
Surgical interventions may be supportive or targeted towards the
lymphatic disease. Supportive procedures include surgical stabilization
of fractures and chest tube drainage. Examples of targeted surgical
interventions include laser ablation of lymphatic vesicles, excisional
debulking, lymphatico-venous anastomosis and thoracic duct
re-implantation. If applicable, medical therapies should be attempted
prior to surgical intervention. To illustrate, placing hardware to
stabilize bone affected by CLA often results in hardware failure,
lymphatic fluid or CSF leakage, and post-operative infection. Surgery
may be avoided by first treating with disease-modifying agents such as
sirolimus and zoledronic acid.