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上肢和下肢淋巴水肿的手术治疗和康复策略:全面综述。

Surgical Treatment and Rehabilitation Strategies for Upper and Lower Extremity Lymphedema: A Comprehensive Review.

机构信息

Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", 88100 Catanzaro, Italy.

Plastic Surgery and Microsurgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56122 Pisa, Italy.

出版信息

Medicina (Kaunas). 2022 Jul 19;58(7):954. doi: 10.3390/medicina58070954.

Abstract

Lymphedema is a chronic disabling condition affecting a growing number of patients worldwide. Although lymphedema is not life-threatening, several reports underlined detrimental consequences in terms of distress, pain, functional impairment, and infections with a relevant decrease in quality of life. Currently, there is no cure, and the therapeutic management of this condition aims at slowing down the disease progression and preventing secondary complications. Early diagnosis is paramount to enhance the effects of rehabilitation or surgical treatments. On the other hand, a multidisciplinary treatment should be truly integrated, the combination of microsurgical and reductive procedures should be considered a valid strategy to manage extremity lymphedema, and rehabilitation should be considered the cornerstone of the multidisciplinary treatment not only for patients not suitable for surgical interventions but also before and after surgical procedures. Therefore, a specialized management of Plastic Reconstructive Surgeons and Physical and Rehabilitative Medicine physicians should be mandatory to address patients' needs and optimize the treatment of this disabling and detrimental condition. Therefore, the aim of this review was to characterize the comprehensive management of lymphedema, providing a broad overview of the potential therapy available in the current literature to optimize the comprehensive management of lymphedema and minimize complications.

摘要

淋巴水肿是一种影响全球越来越多患者的慢性致残性疾病。尽管淋巴水肿不会危及生命,但有几项报告强调了其在痛苦、疼痛、功能障碍和感染方面的不利后果,生活质量显著下降。目前尚无治愈方法,这种疾病的治疗管理旨在减缓疾病进展并预防继发性并发症。早期诊断至关重要,可增强康复或手术治疗的效果。另一方面,多学科治疗应真正融合,显微外科和减少手术的联合应被视为管理肢体淋巴水肿的有效策略,康复应被视为多学科治疗的基石,不仅适用于不适合手术干预的患者,也适用于手术前后。因此,整形外科医生和物理与康复医学医生的专业管理对于满足患者的需求和优化这种致残和有害疾病的治疗是强制性的。因此,本综述的目的是描述淋巴水肿的综合管理,提供当前文献中可用的潜在治疗方法的广泛概述,以优化淋巴水肿的综合管理并最小化并发症。

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