Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany.
Center of Physical and Rehabilitative Medicine, Städtisches Klinikum Dresden, Dresden, Germany.
Dermatol Ther. 2019 Mar;32(2):e12820. doi: 10.1111/dth.12820. Epub 2019 Jan 30.
Lipedema is a painful disease of subcutaneous adipose tissue leading to bilateral increase of leg and/or arm volume, but sparing hands and feet. Although conservative treatment with complex decongestive therapy has been considered as the fundamental treatment, micro-cannular liposuction in tumescent anesthesia has become a surgical option. We report on 111 patients mostly with advanced lipedema treated by this technique in our center between 2007 and 2018. The median age of the patients was 44 years. Eighty percent of patients had at least one comorbidity. There was an association of longstanding and advanced disease to obesity and diseases of the metabolic syndrome-spectrum. The median total amount of lipoaspirate was 4,700 ml, with a range of 950-14,250 ml. The median reduction of limb circumference was 6 cm. The median pain level before treatment was 7.8 and 2.2 at the end of the treatment. An improvement of mobility could be achieved in all patients. Bruising was also reduced. Serious adverse events were observed in 1.2% of procedures, the infection rate was 0% and the bleeding rate was 0.3%. Liposuction is an effective treatment for painful lipedema. The procedure should be performed in specialized centers.
脂肪水肿是一种疼痛性皮下脂肪组织疾病，导致腿部和/或手臂双侧体积增加，但手和脚不受影响。尽管复杂消肿疗法的保守治疗被认为是基本治疗方法，但肿胀麻醉下的微管吸脂术已成为一种手术选择。我们报告了在 2007 年至 2018 年期间，我们中心采用这种技术治疗的 111 例主要为晚期脂肪水肿患者的情况。患者的中位年龄为 44 岁。80%的患者至少有一种合并症。长期和晚期疾病与肥胖和代谢综合征相关疾病有关。吸脂总量中位数为 4700ml，范围为 950-14250ml。肢体周长的中位数减少了 6 厘米。治疗前的中位疼痛水平为 7.8，治疗结束时为 2.2。所有患者的活动能力都得到了改善。瘀伤也减少了。1.2%的手术中观察到严重不良事件，感染率为 0%，出血率为 0.3%。吸脂术是治疗疼痛性脂肪水肿的有效方法。该手术应在专业中心进行。
