Surgical Prevention of Arm Lymphedema After Breast Cancer Treatment
Surgical Prevention of Arm Lymphedema After Breast Cancer Treatment
复制标题
DOI：
10.1245/s10434-011-1624-4
复制
发表时间：
2011-09-01
影响因子：
3.7
通讯作者：
Campisi, Corradino
中科院分区：
文献类型：
--
作者：
Boccardo, Francesco M.;Casabona, Federico;Campisi, Corradino
为前瞻性评估淋巴显微外科预防性愈合方法（LYMPHA）预防乳腺癌腋窝淋巴结清扫术（AD）后水肿的有效性，在2008年3月至2009年9月接受完全AD的49名连续女性中，46名随机分为2组。23名患者接受了LYMPHA技术以预防手臂水肿。另23例患者未行预防性手术（对照组）。LYMPHA手术包括在AD时进行血管-静脉栓塞术（LVA）。所有患者均接受术前淋巴结造影（LS）。通过容量法在1、3、6、12和18个月时对患者进行临床随访。术后，41例患者（治疗组21例，对照组20例）在18个月后进行了LS。治疗组术后6个月出现淋巴水肿1例（4.34%）。对照组7例（30.43%）出现水肿。随访期间，治疗组的手臂体积无统计学显著差异，而对照组的手臂体积在术后1、3和6个月后显著增加。术后1、3、6、12和18个月，两组之间相对于基线的体积变化存在显著差异（每个时间点P值< 0.01）。LYMPHA代表了一种有效的一级预防继发性手臂水肿的技术，没有在腋窝留下未检测到的恶性疾病的风险。
To prospectively assess the efficacy of the lymphatic microsurgical preventive healing approach (LYMPHA) to prevent lymphedema after axillary dissection (AD) for breast cancer treatment.Among 49 consecutive women referred from March 2008 to September 2009 to undergo complete AD, 46 were randomly divided in 2 groups. Twenty-three underwent the LYMPHA technique for the prevention of arm lymphedema. The other 23 patients had no preventive surgical approach (control group). The LYMPHA procedure consisted of performing lymphatic-venous anastomoses (LVA) at the time of AD. All patients underwent preoperative lymphoscintigraphy (LS). Patients were followed up clinically at 1, 3, 6, 12, and 18 months by volumetry. Postoperatively, LS was performed after 18 months in 41 patients (21 treatment group and 20 control group). Arm volume and LS alterations were assessed.Lymphedema appeared in 1 patient in the treatment group 6 months after surgery (4.34%). In the control group, lymphedema occurred in 7 patients (30.43%). No statistically significant differences in the arm volume were observed in the treatment group during follow-up, while the arm volume in the control group showed a significant increase after 1, 3, and 6 months from operation. There was significant difference between the 2 groups in the volume changes with respect to baseline after 1, 3, 6, 12, and 18 months after surgery (every timing P value < 0.01).LYMPHA represents a valid technique for primary prevention of secondary arm lymphedema with no risk of leaving undetected malignant disease in the axilla.