MICROSURGERY FOR LYMPHEDEMA: CLINICAL RESEARCH AND LONG-TERM RESULTS
MICROSURGERY FOR LYMPHEDEMA: CLINICAL RESEARCH AND LONG-TERM RESULTS
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DOI：
10.1002/micr.20737
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发表时间：
2010-01-01
期刊：
影响因子：
2.1
通讯作者：
Boccardo, Francesco
中科院分区：
文献类型：
--
作者：
Campisi, Corradino;Bellini, Carlo;Boccardo, Francesco
目的：报道显微外科手术治疗周围性水肿的广泛临床经验和研究。方法：采用显微外科技术治疗了1800多例外周淋巴水肿患者。衍生的淋巴微血管手术如今被认为是其在多发性动脉-静脉血栓（LVA）中最典型的应用。在相关静脉疾病的情况下，重建淋巴显微外科技术已经发展起来。通过水容量法和淋巴管造影进行客观评估。结果：87%的患者主观症状改善。客观上，83%的患者的容量变化显示出显著改善，平均减少了67%的多余容量。在随访的患者中，85%能够停止使用保守措施，平均随访时间超过10年，多余体积平均减少69%。显微手术后蜂窝织炎的发生率降低了87%。结论：显微外科LVA在治疗外周性水肿中占有一席之地，对于非手术治疗效果不佳的患者应作为首选治疗。(c)2010 Wiley-Liss，Inc.显微外科30：256-260，2010。
Objectives: To report the wide clinical experience and the research studies in the microsurgical treatment of peripheral lymphedema. Methods: More than 1800 patients with peripheral lymphedema have been treated with microsurgical techniques. Derivative lymphatic microvascular procedures recognize today its most exemplary application in multiple lymphatic-venous anastomoses (LVA). In case of associated venous disease reconstructive lymphatic microsurgery techniques have been developed. Objective assessment was undertaken by water volumetry and lymphoscintigraphy. Results: Subjective improvement was noted in 87% of patients. Objectively, volume changes showed a significant improvement in 83%, with an average reduction of 67% of the excess volume. Of those patients followed-up, 85% have been able to discontinue the use of conservative measures, with an average follow-up of more than 10 years and average reduction in excess volume of 69%. There was a 87% reduction in the incidence of cellulitis after microsurgery. Conclusions: Microsurgical LVA have a place in the treatment of peripheral lymphedema, and should be the therapy of choice in patients who are not sufficiently responsive to nonsurgical treatment. (c) 2010 Wiley-Liss, Inc. Microsurgery 30:256-260, 2010.