Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065; email:
Plastic and Reconstructive Surgery Service, Department of Surgery, Weill Cornell Medical College, New York, NY 10065.
Annu Rev Med. 2018 Jan 29;69:263-276. doi: 10.1146/annurev-med-060116-022900. Epub 2017 Sep 6.
Lymphedema affects up to 1 in 6 patients who undergo treatment for a solid tumor in the United States. Its prevalence has increased as more effective oncologic therapies have improved patient survival, but there remains no definitive cure. Recent research has elucidated new details in the pathogenesis of the disease and has demonstrated that it is fundamentally an immunologic process that ultimately results in inflammation, fibroadipose deposition, impaired lymphangiogenesis, and dysfunctional lymphatic pumping. These findings have allowed for the development of novel medical and surgical therapies that may potentially alter the standard of care for a disease that has largely been treated by compression. This review seeks to provide an overview of the emerging therapies and how they can be utilized for effective management of lymphedema.
在美国，多达 1/6 的接受实体瘤治疗的患者会受到淋巴水肿的影响。随着更有效的肿瘤治疗方法提高了患者的生存率，其患病率有所增加，但仍然没有明确的治愈方法。最近的研究阐明了该疾病发病机制的新细节，并表明它本质上是一种免疫过程，最终导致炎症、纤维脂肪沉积、淋巴管生成受损和淋巴泵送功能障碍。这些发现为新型医学和手术疗法的发展提供了可能，这些疗法可能会改变主要通过压迫来治疗的疾病的护理标准。本综述旨在概述新兴疗法，以及如何将它们用于淋巴水肿的有效管理。
