Lymphedema Microsurgical Preventive Healing Approach: A New Technique for Primary Prevention of Arm Lymphedema After Mastectomy
Lymphedema Microsurgical Preventive Healing Approach: A New Technique for Primary Prevention of Arm Lymphedema After Mastectomy
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DOI：
10.1245/s10434-008-0270-y
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发表时间：
2009-03-01
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;Casabona, Federico;Campisi, Corradino
本文的目的是评估直接淋巴静脉显微手术在预防乳腺癌腋窝清扫后淋巴水肿的疗效。19例需要进行腋窝清扫术的可手术乳腺癌患者接受了手术，同时在蓝色淋巴管和腋窝静脉分支之间进行了LVA。术后6个月和12个月的随访包括所有病例的周长测量，19例患者中只有18例患者的淋巴管显像。19例患者中有18例发现与淋巴臂引流有关的蓝色淋巴结。全部切除蓝色淋巴结，准备2-4条上肢主要传入淋巴管用于吻合。淋巴-静脉吻合术在所有病例中均可防止淋巴水肿。淋巴管显像显示微血管吻合口通畅。腋窝淋巴结的破坏和上臂淋巴管的关闭可以解释腋窝淋巴结清扫后淋巴水肿的高危险性。为了防止手臂淋巴水肿，LVA被证明是一种安全的手术。
The purpose of this manuscript is to assess the efficacy of direct lymphaticvenous microsurgery in the prevention of lymphedema following axillary dissection for breast cancer.Nineteen patients with operable breast cancer requiring an axillary dissection underwent surgery, carrying out LVA between the blue lymphatics and an axillary vein branch simultaneously. The follow-up after 6 and 12 months from the operation included circumferential measurements in all cases and lymphangioscintigraphy only in 18 patients out of 19 cases.Blue nodes in relation to lymphatic arm drainage were identified in 18/19 patients. All blue nodes were resected and 2-4 main afferent lymphatics from the arm could be prepared and used for anastomoses. Lymphatic-venous anastomoses allowed to prevent lymphedema in all cases. Lymphangioscintigraphy demonstrated the patency of microvascular anastomoses.Disruption of the blue nodes and closure of arm lymphatics can explain the significantly high risk of lymphedema after axillary dissection. LVA proved to be a safe procedure for patients in order to prevent arm lymphedema.