Koshima I, Inagawa K, Urushibara K, Moriguchi T
Department of Plastic and Reconstructive Surgery, Okayama University Medical School and Kawasaki Medical School, Japan.
J Reconstr Microsurg. 2000 Aug;16(6):437-42. doi: 10.1055/s-2006-947150.
Over the last eight years, the authors analyzed obstructive lymphedema of a unilateral upper extremity in a total of 27 females, comparing the use of supramicrosurgical lymphaticovenule anastomoses and/or conservative treatment. The most common cause of edema was mastectomy, with or without subsequent radiation therapy for breast cancer. As an objective assessment of the extent of edema, the circumferences of the affected and opposite normal forearms were measured at 10 cm below the olecranon of the arm. Twelve of these patients received continual bandaging. In these patients, the average excess circumference of the affected arm was 6.4 cm over that of the normal forearm; the average duration of edema before treatment was 3.5 years; the average period for conservative treatment was 10.6 months; and the average decrease in circumference was 0.8 cm (11.7 percent of the preoperative excess). Twelve patients underwent surgery and postoperative continual bandaging. In these patients, the average excess circumference was 8.9 cm; the average duration of edema before surgery was 8.2 years; the average follow-up after surgery was 2.2 years; and the average decrease in circumference was 4.1 cm (47.3 percent of the preoperative excess). These results indicated that supermicrolymphaticovenular anastomoses with postoperative bandaging have a valuable place in the treatment of obstructive lymphedema.
在过去八年中，作者对27例单侧上肢阻塞性淋巴水肿的女性患者进行了分析，比较了超显微淋巴管静脉吻合术和/或保守治疗的应用情况。水肿的最常见原因是乳腺癌根治术，无论是否随后进行乳腺癌放疗。作为水肿程度的客观评估，在手臂鹰嘴下方10厘米处测量患侧和对侧正常前臂的周长。其中12例患者接受了持续包扎。在这些患者中，患侧手臂比正常前臂的平均周长多出6.4厘米；治疗前水肿的平均持续时间为3.5年；保守治疗的平均时间为10.6个月；周长平均减少0.8厘米（术前多出部分的11.7%）。12例患者接受了手术及术后持续包扎。在这些患者中，平均多出的周长为8.9厘米；手术前水肿的平均持续时间为8.2年；手术后的平均随访时间为2.2年；周长平均减少4.1厘米（术前多出部分的47.3%）。这些结果表明，超显微淋巴管静脉吻合术联合术后包扎在阻塞性淋巴水肿的治疗中具有重要地位。
