Lymph node flap transfer for patients with secondary lower limb lymphedema
Lymph node flap transfer for patients with secondary lower limb lymphedema
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DOI：
10.1002/micr.22404
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发表时间：
2017-01-01
期刊：
影响因子：
2.1
通讯作者：
Becker, Corinne
中科院分区：
文献类型：
--
作者：
Batista, Bernardo N.;Germain, Michel;Becker, Corinne
背景以前的作者已经证明了使用淋巴结皮瓣转移（LNFT）治疗手臂水肿的益处，但很少有证据表明其用于下肢水肿。方法回顾性分析38例52侧41条下肢继发性下肢水肿患者行游离LNFT治疗的临床资料。水肿的原因包括继发于子宫癌子宫切除术、腿部黑色素瘤切除术、淋巴瘤治疗和睾丸癌、肢体整容手术、腹股沟区脂肪瘤切除术和隐静脉切除术的水肿。患者已患水肿平均为9.17.3年的时间LNFT.Results11例（28.9%）保守治疗的轻微并发症。对于23条腿，有足够的数据来跟踪单次LNFT后的肢体体积演变。8条腿的总体积减少（2例患者未测量健康肢体，3例双侧）为7.1 ± 8.6%。另一组15例单侧水肿患者的多余体积平均减少46.3 +/- 34.7%。结论LNFT对继发性下肢水肿患者有较好的疗效（> 30%REV），且术前多余量较少（P=0.045）。结果在患者的轻度介绍似乎比更严重的情况下更好。(c)2014 Wiley Periodicals，Inc.显微外科37：29-33，2017。
BackgroundPrevious authors have shown benefits from the use of lymph node flap transfer (LNFT) to treat lymphedema of the arms, but there is little evidence for its use for lower limb lymphedema. We performed a retrospective analysis of a series of patients suffering from secondary lower limb lymphedema treated with a free LNFT.Methods52 cases of LNFT to treat 41 legs in 38 patients with secondary lymphedema were retrospectively reviewed. The causes of the lymphedema included lymphedema secondary to hysterectomy for uterine cancer, melanoma resections on the leg, lymphoma treatment and testicular cancer, cosmetic surgery to the limb, lipoma resection at the inguinal region, and a saphenectomy. Patients had been suffering with lymphedema for an average of 9.17.3 years at the time of LNFT.ResultsEleven patients (28.9%) presented with minor complications treated conservatively. For 23 legs there was enough data to follow limb volume evolution after a single LNFT. Total volume reduction in eight legs (two patients with no measures of the healthy limb and three bilateral) was 7.1 +/- 8.6%. Another group of 15 patients with unilateral lymphedema had an average 46.3 +/- 34.7% reduction of excess volume. Better results (>30% REV) were associated with smaller preoperative excess volume (P=0.045).ConclusionPatients with secondary leg lymphedema can benefit from LNFT. Results in patients with mild presentations seem to be better than in more severe cases. (c) 2014 Wiley Periodicals, Inc. Microsurgery 37:29-33, 2017.