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[淋巴水肿显微外科治疗的临床进展]

[Clinical progress of microsurgical management for lymphedema].

作者信息

Liu Shiqiang, Ma Xianjie

机构信息

Department of Plastic and Reconstructive Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an Shaanxi, 710032, P.R.China.

Department of Plastic and Reconstructive Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an Shaanxi, 710032,

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Sep 15;32(9):1223-1226. doi: 10.7507/1002-1892.201803018.

DOI:10.7507/1002-1892.201803018
PMID:30129327
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8413988/
Abstract

OBJECTIVE

To review the clinical progress of microsurgical management for lymphedema.

METHODS

The literature on microsurgical treatment for lymphedema at home and abroad in recent years was reviewed and analyzed.

RESULTS

At present, conservative treatment is the main treatment for lymphedema, which has limited effectiveness only for early stages of lymphedema; and it is not curative and demands patient compliance. In contrast, microsurgical approaches can solve the problems in the prevention or management of lymphedema and showed promising results, such as lymphatic-venous anastomosis (LVA), vascularized lymph node transfer (VLNT), and other lymphatic reconstructions.

CONCLUSION

Microsurgical approaches like LVA and VLNT have been broadly used in recent years, the effectiveness and safety have been proved. But the evidence of long-term randomized controlled studies is still required to establish standard treatment practices.

摘要

目的

回顾显微外科治疗淋巴水肿的临床进展。

方法

对近年来国内外有关淋巴水肿显微外科治疗的文献进行回顾与分析。

结果

目前,保守治疗是淋巴水肿的主要治疗方法,仅对淋巴水肿早期有效,且非根治性治疗,需要患者配合。相比之下,显微外科手术方法可以解决淋巴水肿预防或治疗中的问题,并显示出良好的效果,如淋巴管静脉吻合术(LVA)、带血管蒂淋巴结转移术(VLNT)和其他淋巴重建手术。

结论

近年来,LVA和VLNT等显微外科手术方法已被广泛应用,其有效性和安全性已得到证实。但仍需要长期随机对照研究的证据来确立标准治疗方案。

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本文引用的文献

1
Latissimus dorsi flap with vascularized lymph node transfer for lymphedema treatment: Technique, outcomes, indications and review of literature.带血管化淋巴结转移的背阔肌皮瓣治疗淋巴水肿:技术、结果、适应证及文献综述
J Surg Oncol. 2017 Jan;115(1):72-77. doi: 10.1002/jso.24347. Epub 2016 Dec 12.
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Management of lymphoedema.淋巴水肿的管理
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Understanding the Concepts and Physiologic Principles of Lymphatic Microsurgery.
J Reconstr Microsurg. 2016 Oct;32(8):571-579. doi: 10.1055/s-0036-1584570. Epub 2016 Jun 21.
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Vascularized lymph node transfer and lymphovenous bypass: Novel treatment strategies for symptomatic lymphedema.带血管蒂淋巴结转移术和淋巴静脉旁路术:症状性淋巴水肿的新型治疗策略。
J Surg Oncol. 2016 Jun;113(8):932-9. doi: 10.1002/jso.24171. Epub 2016 Feb 5.
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Lymphedema surgery: Patient selection and an overview of surgical techniques.淋巴水肿手术:患者选择及手术技术概述
J Surg Oncol. 2016 Jun;113(8):923-31. doi: 10.1002/jso.24170. Epub 2016 Feb 5.
6
Lymphedema: A General Outline of Its Anatomical Base.淋巴水肿:其解剖学基础概述
J Reconstr Microsurg. 2016 Jan;32(1):2-9. doi: 10.1055/s-0035-1560038. Epub 2015 Sep 16.
7
Laparoscopic Free Omental Lymphatic Flap for the Treatment of Lymphedema.腹腔镜游离网膜淋巴皮瓣治疗淋巴水肿。
Plast Reconstr Surg. 2015 Jul;136(1):114-118. doi: 10.1097/PRS.0000000000001374.
8
Indication of Lymphaticovenous Anastomosis for Lower Limb Primary Lymphedema.下肢原发性淋巴水肿的淋巴管静脉吻合术适应症
Plast Reconstr Surg. 2015 Oct;136(4):883-893. doi: 10.1097/PRS.0000000000001631.
9
A Single-Site Technique of Multiple Lymphatic-Venous Anastomoses for the Treatment of Peripheral Lymphedema: Long-Term Clinical Outcome.一种用于治疗周围性淋巴水肿的多点淋巴管-静脉吻合单部位技术:长期临床结果
J Reconstr Microsurg. 2016 Jan;32(1):42-9. doi: 10.1055/s-0035-1549163. Epub 2015 Jun 1.
10
An algorithmic approach to simultaneous vascularized lymph node transfer with microvascular breast reconstruction.一种用于微血管乳房重建同时进行带血管蒂淋巴结转移的算法方法。
Ann Surg Oncol. 2015 Sep;22(9):2919-24. doi: 10.1245/s10434-015-4408-4. Epub 2015 Jan 27.