Los Angeles, Calif.
From the Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California; and the Division of Plastic and Maxillofacial Surgery, Children's Hospital of Los Angeles.
Plast Reconstr Surg. 2018 Jun;141(6):1550-1557. doi: 10.1097/PRS.0000000000004417.
Patients with lymphedema refractory to medical treatment often have unrealistic expectations for lymphedema surgery. The purpose of this study was to assess patient expectations following lymphedema surgery.
Patients presenting to the clinic for initial evaluation for lymphedema surgery were offered to complete a survey designed to evaluate their expectations for limb appearance, limb function, and overall well-being following lymphedema surgery. The patients were instructed to score each item using a five-point scale for improvement. A mean expectation score was calculated, which was then used to estimate the effects of preoperative variables on patients expectations using multiple regression analysis.
A total of 21 women and two men with a mean age of 60 years completed the survey. The upper limbs were affected in 10 patients and the lower limbs were affected in 13 patients. Physicians were the initial source of information about lymphedema surgery as a potential treatment option in 10 patients (43 percent), and a majority of the patients [n = 15 (65.2 percent)] thought that the physicians had fair or poor knowledge about lymphedema surgery. Significant or complete improvement was expected by 43.4 to 73.9 percent of patients. Patients' level of education, the disease duration, and the initial source of information about lymphedema surgery had a statistically significant impact on patients' expectations.
Early data suggest that most patients learn about lymphedema surgery from nonphysicians, with many expecting complete or significant improvement of lymphedema-associated symptoms with surgery. These findings emphasize the importance of addressing patient expectations and providing appropriate counseling before surgery.
对药物治疗无反应的淋巴水肿患者通常对淋巴水肿手术抱有不切实际的期望。本研究旨在评估淋巴水肿手术后患者的期望。
向到诊所接受淋巴水肿手术初始评估的患者提供一项调查，旨在评估他们对术后肢体外观、肢体功能和整体健康状况的期望。患者被指示使用五分制对每项进行评分以评估改善程度。计算平均期望评分，然后使用多元回归分析来估计术前变量对患者期望的影响。
共有 21 名女性和 2 名男性，平均年龄为 60 岁，完成了调查。10 名患者上肢受累，13 名患者下肢受累。10 名患者（43%）最初是从医生那里了解到淋巴水肿手术作为一种潜在的治疗选择，大多数患者[n=15（65.2%）]认为医生对淋巴水肿手术的了解程度一般或较差。43.4%至 73.9%的患者期望有显著或完全的改善。患者的教育程度、疾病持续时间以及关于淋巴水肿手术的初始信息来源对患者的期望有统计学意义的影响。
早期数据表明，大多数患者从非医生那里了解到淋巴水肿手术，许多患者期望手术能完全或显著改善淋巴水肿相关症状。这些发现强调了在手术前解决患者期望并提供适当咨询的重要性。
