Cornelissen Anouk J M, Beugels Jop, Ewalds Lotte, Heuts Esther M, Keuter Xavier H A, Piatkowski Andrzej, van der Hulst René R W J, Qiu Shao Shan Shan
1 Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center Maastricht , The Netherlands .
2 Department of General Surgery, Maastricht University Medical Center Maastricht , The Netherlands .
Lymphat Res Biol. 2018 Oct;16(5):426-434. doi: 10.1089/lrb.2017.0067. Epub 2018 Jan 22.
Lymphedema affects ∼15% of all patients after breast cancer treatment. The aim of this review was to assess the clinical effects (improvement in arm circumference and quality of life) of lymphaticovenous anastomosis (LVA) in treating breast cancer-related lymphedema (BCRL).
A systematic literature search was conducted in Medline, Embase and the Cochrane Library in July 2017, to identify all studies on LVA for the treatment of BCRL. The primary outcome was limb volume or circumference reduction and the secondary outcome was the improvement of quality of life. The search yielded 686 results, of which 15 articles were included in this review. All studies reported on BCRL in terms of volume or circumference reduction. Thirteen out of the included studies reported a positive surgical effect on reduction in volume or circumference. Twelve articles mentioned qualitative measures, being symptom improvement and improvement in quality of life. The number of patients who experienced symptoms relief ranged from 50% to 100% in the studies.
The current review showed that the effects of LVA for the treatment of BCRL are variable among studies, although overall LVA seems effective in early stage BCRL. Higher quality studies are needed to confirm the effectiveness of LVA.
乳腺癌治疗后，约15%的患者会发生淋巴水肿。本综述旨在评估淋巴管静脉吻合术（LVA）治疗乳腺癌相关淋巴水肿（BCRL）的临床效果（手臂周长改善和生活质量提高）。
2017年7月，在Medline、Embase和Cochrane图书馆进行了系统的文献检索，以确定所有关于LVA治疗BCRL的研究。主要结局是肢体体积或周长减小，次要结局是生活质量改善。检索结果为686条，其中15篇文章纳入本综述。所有研究均报告了BCRL的体积或周长减小情况。纳入的研究中有13项报告了手术对体积或周长减小有积极效果。12篇文章提到了定性指标，即症状改善和生活质量提高。各研究中症状缓解的患者比例在50%至100%之间。
当前综述表明，LVA治疗BCRL的效果在不同研究中存在差异，尽管总体上LVA似乎对早期BCRL有效。需要更高质量的研究来证实LVA的有效性。
