Boccardo Francesco, Casabona Federico, De Cian Franco, Friedman Daniele, Murelli Federica, Puglisi Maria, Campisi Corrado C, Molinari Lidia, Spinaci Stefano, Dessalvi Sara, Campisi Corradino
Department of Surgery-Unit of Lymphatic Surgery, IRCCS S. Martino University Hospital-IST, National Institute for Cancer Research, University of Genoa, Largo R. Benzi 10, 16132, Genoa, Italy.
Microsurgery. 2014 Sep;34(6):421-4. doi: 10.1002/micr.22254. Epub 2014 Mar 26.
Breast cancer-related lymphedema (LE) represents an important morbidity that jeopardizes breast cancer patients' quality of life. Different attempts to prevent LE brought about improvements in the incidence of the pathology but LE still represents a frequent occurrence in breast cancer survivors. Over 4 years ago, Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) was proposed and long-term results are reported in this study. From July 2008 to December 2012, 74 patients underwent axillary nodal dissection for breast cancer treatment together with LYMPHA procedure. Volumetry was performed preoperatively in all patients and after 1, 3, 6, 12 months, and once a year. Lymphoscintigraphy was performed in 45 patients preoperatively and in 30 also postoperatively after at least over 1 year. Seventy one patients had no sign of LE, and volumetry was coincident to preoperative condition. In three patients, LE occurred after 8-12 months postoperatively. Lymphoscintigraphy showed the patency of lymphatic-venous anastomoses at 1-4 years after operation. LYMPHA technique represents a successful surgical procedure for primary prevention of arm LE in breast cancer patients.
乳腺癌相关淋巴水肿（LE）是一种严重影响乳腺癌患者生活质量的疾病。尽管人们采取了各种措施来预防LE，使得该病症的发病率有所下降，但在乳腺癌幸存者中，LE仍然较为常见。4年多前，我们提出了淋巴显微外科预防愈合方法（LYMPHA），本研究报告了该方法的长期效果。2008年7月至2012年12月，74例患者在接受乳腺癌腋窝淋巴结清扫术的同时接受了LYMPHA手术。所有患者在术前、术后1、3、6、12个月及每年进行一次体积测量。45例患者术前进行了淋巴闪烁显像检查，其中30例在术后至少1年以上也进行了该项检查。71例患者没有LE的迹象，体积测量结果与术前情况相符。3例患者在术后8 - 12个月出现了LE。淋巴闪烁显像显示术后1 - 4年淋巴静脉吻合口通畅。LYMPHA技术是预防乳腺癌患者手臂LE的一种成功的外科手术方法。
