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血管化胃网膜淋巴结转移术显著改善乳腺癌相关淋巴水肿。

Vascularized gastroepiploic lymph node transfer significantly improves breast cancer-related lymphedema.

机构信息

Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of General & Vascular Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Surg Oncol. 2020 Jan;121(1):163-167. doi: 10.1002/jso.25607. Epub 2019 Jul 16.

Abstract

BACKGROUND

Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema. Multiple methods have been described and each has significant disadvantages.

STUDY DESIGN

We performed VLNT in patients with upper extremity lymphedema resulting from breast cancer surgery. We used lymph nodes of the greater curvature of the stomach (VLNTg). We describe outcomes of the patients suffering from postmastectomy lymphedema who received VLNTg for treatment of lymphedema. Harvest from the periphery of the left gastroepiploic vessel was conducted.

RESULTS

We retrospectively reviewed data of 24 female patients suffering from lymphedema following breast cancer treatment who underwent lymph node transplantation from 2012 to 2017. Axillary lymphadenectomy had been performed in all cases. In 18 patients, upper limb lymphedema was present for at least 1 year (mean = 5.6 years; range, 1-15 years). In 6 patients, it was present for only a few months (mean = 5 months; range, 3-8 months).

CONCLUSIONS

The greater curvature of the stomach nodes (VLNTg) is an excellent option for the treatment of upper extremity lymphedema because there is no risk of complications and the scar is easily concealed. Improvement from lymphedema can be expected in a majority of patients.

摘要

背景

带血管淋巴结转移(VLNT)是一种治疗淋巴水肿的手术方法。已经描述了多种方法,每种方法都有明显的缺点。

研究设计

我们对因乳腺癌手术导致上肢淋巴水肿的患者进行了 VLNT。我们使用胃大弯的淋巴结(VLNTg)。我们描述了接受 VLNTg 治疗淋巴水肿的乳腺癌根治术后淋巴水肿患者的结局。从胃网膜左血管的外围进行了采集。

结果

我们回顾性分析了 2012 年至 2017 年间接受淋巴结移植治疗乳腺癌后发生淋巴水肿的 24 例女性患者的数据。所有病例均行腋窝淋巴结清扫术。18 例患者上肢淋巴水肿至少 1 年(平均 5.6 年;范围,1-15 年)。6 例患者仅存在数月(平均 5 个月;范围,3-8 个月)。

结论

胃大弯淋巴结(VLNTg)是治疗上肢淋巴水肿的绝佳选择,因为不存在并发症风险,且疤痕易于隐藏。大多数患者的淋巴水肿均可得到改善。

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