Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Southern California, Los Angeles, California, USA.
Lymphat Res Biol. 2021 Feb;19(1):11-16. doi: 10.1089/lrb.2020.0118. Epub 2021 Feb 5.
Lymphedema is a condition characterized by dysfunction of the lymphatic system resulting in chronic, progressive soft tissue edema that can negatively impact individuals' function, self-image, and quality of life. Understanding of the disease process has evolved significantly in the past two decades with advances in diagnostic modalities and surgical techniques revolutionizing prior treatment algorithms. We reviewed our current approach at the University of Southern California to improving outcomes in lymphedema treatment. Given the complexity of this medical condition, patients are best served by a multidisciplinary approach. At our institution, this involves a collaborative effort between bench researchers, lymphatic therapists, medical physicians, and lymphedema surgeons. Basic science and translational research provide further understanding into the underlying mechanisms of lymphangiogenesis and the possibility for potential therapeutic interventions. Our surgical algorithms require patients to undergo a thorough diagnostic evaluation and consultation with certified lymphatic therapists prior to undergoing either physiologic or debulking operations. Patients are followed clinically following any interventions. Further community outreach and education is carried out in order to improve upon early diagnosis and symptom recognition. Optimizing lymphedema care requires a collaborative interplay between researchers, physicians, and therapists. Additionally, patient and provider education on early disease recognition and treatment options is an equally critical aspect of improving patient outcomes.
淋巴水肿是一种以淋巴系统功能障碍为特征的疾病,导致慢性、进行性软组织水肿,可能对个人的功能、自我形象和生活质量产生负面影响。在过去的二十年中,随着诊断模式和手术技术的进步,对疾病过程的认识有了显著的发展,这彻底改变了先前的治疗方案。我们回顾了南加州大学在改善淋巴水肿治疗效果方面的现有方法。鉴于这种疾病的复杂性,多学科方法是为患者提供最佳服务的方法。在我们的机构中,这涉及到基础研究人员、淋巴治疗师、内科医生和淋巴水肿外科医生之间的协作努力。基础科学和转化研究进一步深入了解淋巴管生成的潜在机制以及可能的治疗干预措施。我们的手术方案要求患者在接受生理或去瘤手术之前,先进行全面的诊断评估和与认证的淋巴治疗师咨询。在进行任何干预后,我们会对患者进行临床随访。进一步的社区外展和教育旨在改善早期诊断和症状识别。优化淋巴水肿护理需要研究人员、医生和治疗师之间的协作。此外,患者和提供者对早期疾病识别和治疗选择的教育也是改善患者预后的同等关键方面。