Lymphology Association of North America (LANA) Practice Exam

Which anastomoses pathways should be used for bilateral lower extremity lymphedema?

1. Ipsilateral inguinal-axillary and inter-inguinal

2. Bilateral inguinal-axillary

3. Inter-inguinal and inter-axillary

4. Bilateral inguinal-axillary and inter-inguinal

The correct answer is: Bilateral inguinal-axillary and inter-inguinal

Using bilateral inguinal-axillary and inter-inguinal anastomoses pathways is the most appropriate choice for managing bilateral lower extremity lymphedema. This approach effectively facilitates lymphatic drainage by creating connections between the lymphatic systems of both lower extremities and the upper body. Bilateral inguinal-axillary anastomoses allow for the diversion of lymph fluid from the lower extremities to the axillary nodes, enhancing the capacity for lymphatic drainage. This is particularly important in cases of bilateral lymphedema, where both legs are affected and maintaining effective lymphatic function is crucial for reducing swelling and managing symptoms. The inclusion of inter-inguinal anastomoses further supports this drainage by providing additional pathways for lymph fluid to travel safely between the left and right inguinal regions. This dual approach ensures that the lymphatic load can be balanced and managed more efficiently, improving overall outcomes for patients with bilateral lower extremity lymphedema. Other options, while they may include some relevant pathways, lack the comprehensive strategy that addresses the need for drainage from both affected areas effectively. The correct choice integrates multiple pathways that work synergistically to address bilateral conditions optimally.