Al-Tarrah Khaled, Ashour Tarek, Rao Rajashankar, Rayatt Sukhbir, Thomas Sunil S
Department of Plastic Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham Foundation Trust, Mindelsohn Way, Birmingham, UK.
Institute of Inflammation and Ageing, Birmingham University Medical School, Birmingham, UK.
Plast Reconstr Surg Glob Open. 2020 Jan 17;8(1):e2601. doi: 10.1097/GOX.0000000000002601. eCollection 2020 Jan.
Massive localized lymphedema of the abdomen is a rare condition resulting from a neglected lower abdominal pannus associated with significant disability and morbidity. Compared to other surgical procedures, postbariatric surgery is usually considered a financial drain. In the United Kingdom, this requires National Health Service approval and delays may lead to sequelae that adversely impact on patients' quality of life with increased morbidity. We present a wheelchair-bound patient whose body mass index increased from 53 to 82, while awaiting funding approval increasing her anesthetic and surgical risks. A multidisciplinary approach is mandatory for preoperative, intraoperative, and postoperative care for these patients including anesthetic input and high dependency unit care. Managing this patient was a significant anesthetic and surgical challenge with 47-kg resected tissue. The planning and perioperative measures to minimize morbidity are discussed.
腹部巨大局限性淋巴水肿是一种罕见病症，由被忽视的下腹部赘肉引起，会导致严重残疾和发病。与其他外科手术相比，减肥手术后的治疗通常被认为费用高昂。在英国，这需要获得国民医疗服务体系的批准，而延迟可能导致后遗症，对患者的生活质量产生不利影响，增加发病率。我们介绍一位依赖轮椅的患者，其体重指数从53增至82，在等待资金批准期间，她的麻醉和手术风险不断增加。对于这些患者，术前、术中和术后护理采用多学科方法是必不可少的，包括麻醉支持和重症监护病房护理。处理这位患者是一项重大的麻醉和手术挑战，切除组织达47千克。本文讨论了将发病率降至最低的规划和围手术期措施。
