Cintra Júnior Wilson, Modolin Miguel Luiz Antonio, Rocha Rodrigo Itocazo, Fernandes Thadeu Rangel, Nogueira Ariel Barreto, Gemperli Rolf
Clinics Hospital, Faculty of Medicine, University of São Paulo.
Department of Plastic Surgery, Faculty of Medicine, University of São Paulo.
Rev Col Bras Cir. 2014 Jan-Feb;41(1):18-22. doi: 10.1590/s0100-69912014000100005.
to evaluate the importance of treatment of deformities caused by massive localized lymphedema (MLL) in the severely obese.
in a period of seven years, nine patients with morbid obesity and a mean age of 33 years underwent surgical resection of massive localized lymphedema with primary synthesis. This is a retrospective study on the surgical technique, complication rates and improved quality of life.
all patients reported significant improvement after surgery, with greater range of motion, ambulation with ease and more effective hygiene. Histological analysis demonstrated the existence of a chronic inflammatory process marked by lymphomonocitary infiltrate and severe tissue edema. We observed foci of necrosis, formation of microabscesses, points of suppuration and local fibrosis organization, and pachydermia. The lymphatic vessels and some blood capillaries were increased, depicting a framework of linfangiectasias.
surgical treatment of MLL proved to be important for improving patients' quality of life, functionally rehabilitating them and optimizing multidisciplinary follow-up of morbid obesity, with satisfactory surgical results and acceptable complication rates, demonstrating the importance of treatment and awareness about the disease.
评估治疗重度肥胖患者中由大量局限性淋巴水肿（MLL）引起的畸形的重要性。
在七年时间里，9例平均年龄33岁的病态肥胖患者接受了原发性缝合的大量局限性淋巴水肿手术切除。这是一项关于手术技术、并发症发生率及生活质量改善情况的回顾性研究。
所有患者术后均报告有显著改善，活动范围更大、行走轻松且卫生状况更良好。组织学分析显示存在以淋巴细胞单核细胞浸润和严重组织水肿为特征的慢性炎症过程。我们观察到坏死灶、微脓肿形成、化脓点及局部纤维化组织，还有皮肤增厚。淋巴管和一些毛细血管增多，呈现出淋巴管扩张的结构。
MLL的手术治疗被证明对于改善患者生活质量、使其功能康复以及优化病态肥胖的多学科随访很重要，手术结果令人满意且并发症发生率可接受，证明了治疗及对该疾病认识的重要性。
