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慢性淋巴水肿手术治疗创新方法的长期效果

Long Term Results of Innovative Procedure in Surgical Management of Chronic Lymphedema.

作者信息

Mousavi Seyed R

机构信息

Shohada Medical Center and Cancer Research Center, Vascular Department, Shahid Beheshti University Medical Sciences, Tehran, Iran.

出版信息

Open Orthop J. 2016 Nov 17;10:543-549. doi: 10.2174/1874325001610010543. eCollection 2016.

Abstract

BACKGROUND

Lymphedema is the result of impaired lymphatic drainage by the affected organ. This abnormality can be primary or secondary. Different operative approaches have been introduced to treat chronic lymphedema.

MATERIALS AND METHODS

This retrospective study included 816 patients who were diagnosed with chronic lower extremity lymphedema and did not respond to non-operative management for at least six months. Data was collected over 25 years, between March 1987 and March 2013. Doppler ultrasonography of the deep venous system was routinely undertaken in all patients to confirm patency. The patients underwent surgery and their progress was followed for at least one year postoperatively.

RESULTS

All patients were operated by the suggested technique and long term fallow-up which is a modified form of the Homan's technique. The outcome was excellent, and 89.2% of patients were free of complication and 2% had poor results. The most common complication was wound seroma and wound infection.

CONCLUSION

The long term results and considering the difficulties associated with the treatment of chronic lymphedema and the variety of surgical options, our method achieved excellent results, and may be proposed for the standard operative procedure for treating intractable forms of this disease.

摘要

背景

淋巴水肿是受影响器官淋巴引流受损的结果。这种异常情况可以是原发性的或继发性的。已经引入了不同的手术方法来治疗慢性淋巴水肿。

材料与方法

这项回顾性研究纳入了816例被诊断为慢性下肢淋巴水肿且至少六个月非手术治疗无效的患者。数据收集于1987年3月至2013年3月的25年间。所有患者均常规进行深静脉系统的多普勒超声检查以确认通畅情况。患者接受了手术,并在术后至少随访一年。

结果

所有患者均采用改良霍曼氏技术的建议方法进行手术及长期随访。结果良好,89.2%的患者无并发症,2%效果不佳。最常见的并发症是伤口血清肿和伤口感染。

结论

考虑到慢性淋巴水肿治疗的困难以及手术选择的多样性,我们的方法取得了良好的长期效果,可作为治疗这种难治性疾病的标准手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/878c/5120377/683c68ec03c4/TOORTHJ-10-543_F1.jpg

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