Raju Ashvin, Chang David W
*Yong Loo Lin School of Medicine, National University of Singapore, Singapore; and †Section of Plastic and Reconstructive Surgery, Department of Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL.
Ann Surg. 2015 May;261(5):1013-23. doi: 10.1097/SLA.0000000000000763.
A comprehensive literature review of VLNT with updates and comparisons on current application, techniques, results, studies and possible future implications.
Lymphedema is a debilitating condition that often results secondary to treatment of cancer. Unfortunately there is no cure. However, microsurgical procedures such as VLNT has gained popularity as there have been increasing reports that VLNT may help alleviate the severity of lymphedema.
A review of literature was conducted over major medical indices (PubMed-MEDLINE, Factiva, Scopus, Sciencedirect, EMBASE). Search terms were focused on vascularized, lymph node transfer (also autologous, lymph node transplant) to cover both human and animal studies. Each study was verified for the nature of the procedure; a free microsurgical flap containing lymph nodes for the purpose of relieving lymphedema.
There are human and animal studies that individually report clear benefits, but because of methodological shortcomings comparative studies with uniform patient selection and monitoring are lacking.
Although the results with the use of VLNT for treatment of lymphedema have been largely positive, further exploration into standardized protocols for diagnosis, treatment optimization, and patient outcomes assessment is needed.
对带血管蒂淋巴结转移术（VLNT）进行全面的文献综述，包括对其当前应用、技术、结果、研究以及未来可能的影响进行更新和比较。
淋巴水肿是一种使人衰弱的病症，通常继发于癌症治疗。不幸的是，目前尚无治愈方法。然而，诸如带血管蒂淋巴结转移术等显微外科手术越来越受欢迎，因为越来越多的报告表明该手术可能有助于减轻淋巴水肿的严重程度。
对主要医学索引数据库（PubMed - MEDLINE、Factiva、Scopus、Sciencedirect、EMBASE）进行文献综述。检索词聚焦于血管化淋巴结转移（也包括自体淋巴结移植），以涵盖人类和动物研究。对每项研究的手术性质进行核实；即用于缓解淋巴水肿的含淋巴结的游离显微外科皮瓣。
有人类和动物研究分别报告了明确的益处，但由于方法学上的缺陷，缺乏具有统一患者选择和监测的比较研究。
尽管使用带血管蒂淋巴结转移术治疗淋巴水肿的结果大多是积极的，但仍需要进一步探索标准化的诊断方案、治疗优化以及患者结局评估。
