Savage R C
Surg Gynecol Obstet. 1985 Mar;160(3):283-90.
The treatment of lymphedema remains a formidable task for the patient and physician. However, most patients with both primary and secondary lymphedema can be managed satisfactorily by conservative means. Surgical intervention for lymphedema should be considered only after a serious trial of medical management. Although no present surgical technique offers cure, significant improvement is possible by a variety of methods. The staged excision of skin and subcutaneous tissue, the Charles procedure and the dermal flap by Thompson are still the most popular techniques in the United States. Axial and myocutaneous flaps and microsurgical bypass procedures are currently under investigation and may hold promise after additional study. Future experimental and clinical studies should concentrate on long term follow-up study with objective clinical and roentgenographic documentation of improvement.
淋巴水肿的治疗对患者和医生来说仍然是一项艰巨的任务。然而，大多数原发性和继发性淋巴水肿患者可以通过保守方法得到满意的治疗。只有在经过认真的药物治疗尝试后，才应考虑对淋巴水肿进行手术干预。虽然目前没有任何手术技术能治愈淋巴水肿，但通过多种方法可以实现显著改善。分期切除皮肤和皮下组织、查尔斯手术以及汤普森的真皮瓣手术在美国仍然是最常用的技术。轴型和肌皮瓣以及显微外科旁路手术目前正在研究中，经过进一步研究可能会有前景。未来的实验和临床研究应集中于长期随访研究，并通过客观的临床和影像学记录来证明改善情况。
