Yamamoto T, Yamamoto N, Giacalone G
Lymphology. 2016 Sep;49(3):128-32.
Breast lymphedema (BLE) can occur after breast cancer treatments, but there have been no cases of BLE secondary to lymph node transfer (LNT) using an axillary lymph node (ALN). We report the first case of LNT-related BLE successfully treated with supermicrosurgical lymphaticovenular anastomosis (LVA). A 50-year-old female presented with left BLE after LNT harvesting from the left axilla for the treatment of secondary lower extremity lymphedema in another hospital. Although the left breast did not seem edematous, the patient suffered from sensation of tension and frequent episodes of left breast cellulitis. Since conservative treatments were not effective, LVA was performed at the lateral thoracic region. A 0.5 mm lymphatic vessel was found and anastomosed to a nearby 0.35 mm vein in an intima-to-intima coaptation manner. After the LVA, the patient experienced no sensation of tension or further cellulitis attacks. Although rarely encountered, BLE can occur after axillary LNT, and LVA may be a useful therapeutic option.
乳腺癌治疗后可能会发生乳腺淋巴水肿（BLE），但尚无因使用腋窝淋巴结（ALN）进行淋巴结转移（LNT）继发BLE的病例。我们报告了首例通过超显微外科淋巴管静脉吻合术（LVA）成功治疗的与LNT相关的BLE病例。一名50岁女性在另一家医院因治疗继发性下肢淋巴水肿而从左腋窝进行LNT采集后出现左乳腺淋巴水肿。尽管左侧乳房看起来没有水肿，但患者感到紧张，且左侧乳房蜂窝织炎频发。由于保守治疗无效，遂在胸外侧区域进行LVA。发现一条0.5毫米的淋巴管，并以内膜对内膜贴合的方式与附近一条0.35毫米的静脉进行吻合。LVA术后，患者不再感到紧张，也未再发生蜂窝织炎。尽管很少见，但腋窝LNT后可能发生BLE，LVA可能是一种有效的治疗选择。
