Shimbo Keisuke, Kawamoto Haruka, Koshima Isao
Department of Plastic and Reconstructive Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan.
Eplasty. 2024 May 9;24:e29. eCollection 2024.
Lymphedema can develop during the progression of neoplastic diseases and is a devastating complication in patients with cancer receiving palliative care. This study aimed to investigate the course of treatment for lymphedema in patients receiving palliative care to assess posttreatment outcomes.
This single-center, retrospective cohort study reviewed the maintained database of patients with lymphedema who presented to our department from January 2015 through December 2022. A combination of skin care, compression therapy, and lymphaticovenular anastomosis was used to treat lymphedema in patients with cancer receiving palliative care. The upper or lower extremity lymphedema indices, calculated based on 5 upper or 4 lower extremity circumferences and body mass index, were compared at the first and last visits.
Of the 202 patients with lymphedema, 38 patients with 45 affected limbs (upper extremities: 11 patients, 12 limbs; lower extremities: 27 patients, 33 limbs) were included in the analysis. There were no significant changes in edema based on the upper or lower extremity lymphedema indices in the upper ( = .931) or lower extremities ( = .767) between the first and last visits. No pain relief was observed after the treatment. In the treatment differences, the rate of change in edema was -3.6 ± 10.8% for the compression garment and +5.7 ± 11.5% for the lymphaticovenular anastomosis, showing no significant difference ( = .157).
All treatments had limited therapeutic effects, such as reduced edema and pain relief, and there were no significant differences between them.
淋巴水肿可在肿瘤性疾病进展过程中发生，是接受姑息治疗的癌症患者的一种严重并发症。本研究旨在调查接受姑息治疗的淋巴水肿患者的治疗过程，以评估治疗后的结果。
这项单中心回顾性队列研究回顾了2015年1月至2022年12月期间到我院就诊的淋巴水肿患者的维护数据库。采用皮肤护理、加压治疗和淋巴管静脉吻合术相结合的方法治疗接受姑息治疗的癌症患者的淋巴水肿。根据5个上肢或4个下肢周长和体重指数计算的上肢或下肢淋巴水肿指数在首次和末次就诊时进行比较。
在202例淋巴水肿患者中，38例患者的45个患肢（上肢：11例患者，12条肢体；下肢：27例患者，33条肢体）纳入分析。首次和末次就诊之间，上肢（P = 0.931）或下肢（P = 0.767）的上肢或下肢淋巴水肿指数所反映的水肿情况无显著变化。治疗后未观察到疼痛缓解。在治疗差异方面，加压衣治疗组水肿变化率为-3.6±10.8%，淋巴管静脉吻合术治疗组为+5.7±11.5%，差异无统计学意义（P = 0.157）。
所有治疗方法的治疗效果有限，如减轻水肿和缓解疼痛，且它们之间无显著差异。
