Kayıran Oğuz, De La Cruz Carolyn, Tane Kaori, Soran Atilla
Division of Breast Surgery and Lymphedema Program, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, USA.
Department of Plastic and Reconstructive Surgery, Baltalimani Hospital, İstanbul, Turkey.
Turk J Surg. 2017 Jun 1;33(2):51-57. doi: 10.5152/turkjsurg.2017.3870. eCollection 2017.
Lymphedema is a chronic and progressive disorder resulting from impaired lymphatic system function. In developed countries, upper extremity lymphedema is mainly the consequence of breast cancer surgery in which axillary lymph node dissection and radiation alter upper extremity lymphatic flow. Diagnosis of lymphedema is made clinically. Nevertheless, there are numerous diagnostic tools available for disease staging. Recently, a new technology namely magnetic resonance lymphangiography has emerged in the medical field to assist in both diagnosis and management. There are non-surgical and surgical treatment options available. Non-surgical methods are always the first-line treatment; however, surgical options can be explored in appropriate patients. Recent studies focus on the prevention of lymphedema using surgical techniques utilizing axillary reverse mapping to delineate arm lymphatics from axillary lymphatics. Finding the most suitable technique for each type of lymphedema with variable stages is one of the most complicated decisions for practitioners. More studies are needed to reveal the exact biology of lymphedema to ensure complete understanding of the disease and improve outcomes.
淋巴水肿是一种由于淋巴系统功能受损导致的慢性进行性疾病。在发达国家，上肢淋巴水肿主要是乳腺癌手术的后果，其中腋窝淋巴结清扫和放疗改变了上肢淋巴液流动。淋巴水肿的诊断依靠临床检查。然而，有许多诊断工具可用于疾病分期。最近，医学领域出现了一种名为磁共振淋巴造影的新技术，有助于诊断和治疗。有非手术和手术治疗方案可供选择。非手术方法始终是一线治疗；然而，合适的患者可以探索手术方案。最近的研究集中在使用手术技术预防淋巴水肿，利用腋窝反向映射从腋窝淋巴管中描绘出手臂淋巴管。为不同分期的每种类型淋巴水肿找到最合适的技术，是从业者最复杂的决策之一。需要更多研究来揭示淋巴水肿的确切生物学机制，以确保对该疾病有全面的了解并改善治疗效果。
