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.