Lee Hyun Seung, Bae Yong Chan, Nam Su Bong, Yi Chang Ryul, Yoon Jin A, Kim Joo Hyoung
Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Arch Plast Surg. 2021 Sep;48(5):534-542. doi: 10.5999/aps.2020.02215. Epub 2021 Sep 15.
During the early stages of lymphedema, active physiologic surgical treatment can be applied. However, lymphedema patients often have limited knowledge and misconceptions regarding lymphedema and surgical treatment. We analyzed the correlations between lymphedema severity and surgical technique according to patients' awareness of surgical treatment for secondary upper extremity lymphedema (UEL).
Patients with UEL diagnosed between December 2017 and December 2019 were retrospectively evaluated. At the time of their presentation to our hospital for the treatment of lymphedema, they were administered a questionnaire about lymphedema and lymphedema surgery. Based on the results, patients were classified as being aware or unaware of surgical treatment. Lymphedema severity was classified according to the arm dermal backflow (ADB) stage and the MD Anderson Cancer Center (MDACC) stage based on indocyanine green lymphography conducted at presentation. Surgical techniques were compared between the two groups.
Patients who were aware of surgical treatment had significantly lower initial ADB and MDACC stages (P<0.05) and more frequently underwent physiologic procedures than excisional procedures (P=0.003).
If patients are actively educated regarding surgical treatment of lymphedema, physiologic procedures may be performed during the early stages of UEL.
在淋巴水肿的早期阶段，可以采用积极的生理性手术治疗。然而，淋巴水肿患者对淋巴水肿和手术治疗的了解往往有限且存在误解。我们根据患者对继发性上肢淋巴水肿（UEL）手术治疗的认知情况，分析了淋巴水肿严重程度与手术技术之间的相关性。
对2017年12月至2019年12月期间诊断为UEL的患者进行回顾性评估。在他们因淋巴水肿到我院就诊时，对其进行了关于淋巴水肿和淋巴水肿手术的问卷调查。根据结果，将患者分为了解或不了解手术治疗两类。根据就诊时进行的吲哚菁绿淋巴造影，依据手臂皮肤回流（ADB）分期和MD安德森癌症中心（MDACC）分期对淋巴水肿严重程度进行分类。比较两组的手术技术。
了解手术治疗的患者初始ADB和MDACC分期显著更低（P<0.05），并且与切除手术相比，更频繁地接受生理性手术（P=0.003）。
如果对患者进行关于淋巴水肿手术治疗的积极教育，在UEL的早期阶段可能会实施生理性手术。
