Lee M, Perry L, Granzow J
Lymphology. 2016 Mar;49(1):36-41.
Chronic lymphedema results from the accumulation of adipose tissue and fibrotic solids and poses a significant challenge for the treating clinician. Despite its many challenges, chronic lymphedema can be safely and effectively treated using a minimally invasive technique known as suction assisted protein lipectomy (SAPL). We present the use of SAPL in a 65-year-old female with a history of chronic, congenital, non-compressible, solid predominant lymphedema for over 40 years. Her lymphedema was complicated by multiple episodes of severe cellulitis that often required hospitalization and treatment with intravenous antibiotics. The patient also had an excisional procedure designed to debulk the lymphedema swelling performed over 35 years prior by an outside provider. The procedure resulted in substantial scarring and fibrosis between the skin and underlying fascia over a significant area of the leg with only minimal improvement in symptoms. Following SAPL, a stable excess volume reduction of 86% was achieved along with a significant improvement in range of motion of the knee. Furthermore, the patient had no further episodes of recurrent cellulitis. We have found SAPL to be effective even in patients with complex, chronic lymphedema presentations with extensive preexisting scarring from prior surgery..
慢性淋巴水肿是由脂肪组织和纤维化固体物质的积聚引起的，给临床治疗医生带来了重大挑战。尽管存在诸多挑战，但慢性淋巴水肿可以通过一种称为吸脂辅助蛋白脂肪切除术（SAPL）的微创技术进行安全有效的治疗。我们介绍了SAPL在一名65岁女性患者中的应用，该患者患有慢性、先天性、不可压缩、以实性为主的淋巴水肿超过40年。她的淋巴水肿并发多次严重蜂窝织炎，常常需要住院并接受静脉抗生素治疗。该患者在35多年前还接受过一次旨在减轻淋巴水肿肿胀的切除手术，由外部医生实施。该手术导致腿部大面积皮肤与深筋膜之间出现大量瘢痕形成和纤维化，症状仅略有改善。接受SAPL治疗后，稳定地减少了86%的多余组织量，同时膝关节活动范围也有显著改善。此外，患者未再出现复发性蜂窝织炎。我们发现，即使对于具有复杂慢性淋巴水肿表现且因既往手术存在广泛瘢痕形成的患者，SAPL也是有效的。
