Chang Kun, Xia Song, Liang Chen, Sun Yuguang, Xin Jianfeng, Shen Wenbin
Department of Lymph Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.
Front Surg. 2023 Mar 15;10:1065733. doi: 10.3389/fsurg.2023.1065733. eCollection 2023.
In this work, we studied the clinical effect of liposuction followed by lymphovenous anastomosis (LVAs) for the treatment of breast cancer-related lymphedema (BCRL).
We analyzed 158 patients with unilateral upper limb BCRL who underwent liposuction followed by LVAs 2-4 months later. Arm circumferences before and 7 days after the combined treatments were prospectively recorded. Circumferences of different upper extremities were measured before the procedure, 7 days after LVAs, and during the follow-ups. Volumes were calculated with the frustum method. During the follow-ups, the conditions of patients' treated arms, i.e., the frequency of erysipelas episodes and dependence on compression garments, were recorded.
The mean circumference difference between two upper limbs decreased significantly from M (P25, P75) of 5.3 (4.1, 6.9) preoperatively to 0.5 (-0.8, 1.0) ( < 0.05) 7 days after treatments, while at follow-up 0.3 (-0.4, 1.0). The mean volume difference decreased significantly from M (P25, P75) of 838.3 (662.4, 1,129.0) preoperatively to 7.8 (-120.3, 151.4) ( < 0.05) 7 days after treatments, while at follow-up 43.7 (-59.4, 161.1). The incidence of erysipelas also significantly decreased ( < 0.05). 6.3% of patients were already independent of compression garments during the past six months or even more.
Liposuction followed by LVAs is an effective method for the treatment of BCRL.
在本研究中，我们探讨了抽脂术联合淋巴静脉吻合术（LVA）治疗乳腺癌相关淋巴水肿（BCRL）的临床效果。
我们分析了158例单侧上肢BCRL患者，这些患者先接受抽脂术，2至4个月后再行LVA。前瞻性记录联合治疗前及治疗后7天的手臂周长。在手术前、LVA术后7天及随访期间测量不同上肢的周长。采用截头圆锥体法计算体积。在随访期间，记录患者治疗手臂的情况，即丹毒发作频率和对加压服装的依赖程度。
治疗后7天，双上肢平均周长差从术前的M（P25，P75）5.3（4.1，6.9）显著降至0.5（-0.8，1.0）（P<0.05），随访时为0.3（-0.4，1.0）。平均体积差从术前的M（P25，P75）838.3（662.4，1129.0）显著降至治疗后7天的7.8（-120.3，151.4）（P<0.05），随访时为43.7（-59.4，161.1）。丹毒发病率也显著降低（P<0.05）。6.3%的患者在过去六个月甚至更长时间内已不再依赖加压服装。
抽脂术联合LVA是治疗BCRL的有效方法。
