Detailed Examination of the Characteristics and Treatment in a Series of 33 Idiopathic Lymphedema Patients.
Detailed Examination of the Characteristics and Treatment in a Series of 33 Idiopathic Lymphedema Patients.
复制标题
对 33 名特发性淋巴水肿患者的一系列特征和治疗进行详细检查。
DOI：
10.1055/s-0036-1586257
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Kimata Y.
中科院分区：
文献类型：
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作者：
Onoda S;Yamada K;Matsumoto K;Kimata Y.
迄今为止，关于特发性淋巴水肿的报道很少，而且大多数都是病例报道。在这一次，我们进行了回顾性审查特发性淋巴水肿患者。方法40例特发性淋巴水肿患者，与手术、损伤、循环系统疾病、肾脏疾病和血栓性静脉疾病等疾病无关。对于这些患者，我们对我们随访的33例患者的水肿发病年龄、性别、水肿的位置和分期、蜂窝织炎的存在、与水肿发病相关的发作、治疗干预和随访时间进行了回顾性回顾。结果33例特发性淋巴水肿患者中，11例为先天性或儿童期淋巴水肿，14例为成年期淋巴水肿，其余8例发病年龄为60 ~ 60岁。33例患者中有20例接受了手术治疗。19例行淋巴小静脉吻合术（LVA）的患者中，2例治疗效果好，4例治疗效果一般，13例治疗效果差。12例患者仅保守治疗，随访3个月以上，未行手术。12例患者的治疗效果：优4例，良6例，一般2例。结论在本研究中，LVA对大多数特发性淋巴水肿患者的有效性尚未得到证实。虽然这篇综述没有包括一个实际的病例，但未来应该考虑新的手术治疗适应症，如血管化淋巴结转移。
BackgroundTo date, only a few reports have been published on idiopathic lymphedema, and most of these are case reports. In this time, we performed a retrospective review of idiopathic lymphedema patients.MethodsForty patients presented with idiopathic lymphedema that was unrelated to surgery, injury, and medical conditions such as circulatory disease, kidney disease, and thrombotic venous disease. For these patients, we performed a retrospective review for edema-onset age, sex, location and stage of the edema, presence of cellulitis, episode related to edema onset, therapeutic intervention, and follow-up duration in the 33 patients whom we followed up.ResultsAmong the 33 patients with idiopathic lymphedema, there were 11 patients with either congenital or childhood-onset lymphedema, 14 with adult-onset lymphedema, and the remaining 8 patients had an onset age of >60 years. Twenty of the 33 patients had undergone surgical treatment. Of the 19 patients who underwent lymphaticovenular anastomosis (LVA), 2 had good, 4 had fair, and 13 had poor treatment outcomes. Twelve patients successfully received only conservative treatment and follow-up for more than 3 months, without operation. The treatment outcome in these 12 patients was as follows: excellent in 4 patients, good in 6, and fair in 2 patients.ConclusionIn this study, the usefulness of LVA for most patients with idiopathic lymphedema was not confirmed. Although this review did not include a conducted case, the indication for new surgical treatments such as vascularized lymph node transfer should be considered in the future.