Postmastectomy lymphedema - Long-term results following microsurgical lymph node transplantation
Postmastectomy lymphedema - Long-term results following microsurgical lymph node transplantation
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DOI：
10.1097/01.sla.0000201258.10304.16
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发表时间：
2006-03-01
影响因子：
9
通讯作者：
Hidden, G
中科院分区：
文献类型：
--
作者：
Becker, C;Assouad, J;Hidden, G
背景与目的：淋巴水肿作为乳腺癌治疗的并发症仍然是一个具有挑战性的问题。本研究的目的是分析显微外科淋巴结（LN）移植后的长期结果。
方法：24名患有淋巴水肿5年以上的女性患者接受了LN移植。她们都经过物理治疗但效果不佳。从股部区域采集淋巴结，转移至腋窝区域，并通过显微外科手术进行移植。根据皮肤弹性、通过测量评估的淋巴水肿减轻或消失情况、同位素淋巴管造影以及停止物理治疗的能力来评估长期结果。
结果：术后恢复顺利；所有患者的皮肤感染性疾病均消失。上肢周长在10例中恢复正常，12例有所减小，2例保持不变。16例同位素淋巴闪烁显像中有5例（31%）显示移植淋巴结有活性。15名患者（62.5%）停止了物理治疗。10名患者被视为治愈，12名患者有显著改善，只有2名患者没有改善。
结论：LN移植是一种安全的手术，在乳房切除术后淋巴水肿方面能取得良好的长期效果，使水肿消失或有显著改善，尤其是在疾病的早期阶段。
Background and Objectives: Lymphedema complicating breast cancer treatment remains a challenging problem. The purpose of this study was to analyze the long-term results following microsurgical lymph node (LN) transplantation.Methods: Twenty-four female patients with lymphedema for more than 5 years underwent LN transplantation. They were treated by physiotherapy and resistant to it. LNs were harvested in the femoral region, transferred to the axillary region, and transplanted by microsurgical procedures. Long-term results were evaluated according to skin elasticity, decrease, or disappearance of lymphedema assessed by measurements, isotopic lymphangiography, and ability to stop physiotherapy.Results: The postoperative period was uneventful; skin infectious diseases disappeared in all patients. Upper limb perimeter returned to normal in 10 cases, decreased in 12 cases, and remained unchanged in 2 cases. Five of 16 (31%) isotopic lymphoscintigraphies demonstrated activity of the transplanted nodes. Physiotherapy was discontinued in 15 patients (62.5%). Ten patients were considered as cured, important improvement was noted in 12 patients, and only 2 patients were not improved.Conclusion: LN transplantation is a safe procedure permitting good long-term results, disappearance, or a noteworthy improvement, in postmastectomy lymphedema, especially in the early stages of the disease.