The Vanderbilt University Medical Center, Nashville, TN, USA.
The Vanderbilt University Medical Center, Nashville, TN, USA.
J Plast Reconstr Aesthet Surg. 2024 Oct;97:256-267. doi: 10.1016/j.bjps.2024.07.038. Epub 2024 Jul 31.
Lipedema is a relatively common, frequently misdiagnosed, chronic condition that is often treated using liposuction when conservative therapies fail. Techniques such as traditional tumescent liposuction (TTL), power-assisted liposuction (PAL), and water-jet-assisted liposuction (WAL) are popular surgical interventions, although it is unclear how these techniques compare. This meta-analysis aimed to assess the efficacy and safety of liposuction in patients with lipedema.
Relevant English lipedema studies published in PubMed from January 2003 to April 2023 were identified. Ten articles with post-operative outcomes and complications data were included (2 TTL, 5 PAL, 1 WAL, and 2 articles used PAL and WAL). Results were summarized using descriptive statistics, and a randomized effects model was used to evaluate heterogeneity.
A total of 2542 procedures in 906 patients were included. Combined outcomes for all techniques significantly improved pain, bruising, edema, tension, pressure sensitivity, cosmetic impairment, and general impairment (all P < 0.00001). TTL, PAL, and WAL led to significant improvements in pain reduction P = 0.0005), bruising, swelling, pressure sensitivity, or cosmetic impairment (all P < 0.05). However, WAL more effectively reduced tension and general impairment (all P < 0.005), but heterogeneity for these outcomes was high. Overall complication rates were low for the studies that used TTL (1.5%), PAL (4.0%), WAL (0%), and both PAL and WAL (2.3%).
Liposuction techniques, including TTL, PAL, and WAL, resulted in significant symptom improvement in patients with lipedema with a relatively low complication rate. WAL may potentially result in a more substantial reduction of tension and general impairment with fewer complications; however, only a single study performed this method of liposuction exclusively. To the best of our knowledge, this is the first meta-analysis investigating liposuction data in lipedema treatment.
脂肪营养不良是一种较为常见的、常被误诊的慢性疾病，当保守治疗失败时，通常采用抽脂术进行治疗。传统肿胀抽脂术（TTL）、动力辅助抽脂术（PAL）和水动力辅助抽脂术（WAL）等技术是常见的手术干预手段，但这些技术的效果如何尚不清楚。本荟萃分析旨在评估抽脂术治疗脂肪营养不良患者的疗效和安全性。
从 2003 年 1 月至 2023 年 4 月，在 PubMed 上检索到有关脂肪营养不良的英文研究。纳入了 10 篇具有术后结果和并发症数据的文章（2 篇 TTL、5 篇 PAL、1 篇 WAL 和 2 篇同时使用 PAL 和 WAL）。使用描述性统计方法总结结果，并采用随机效应模型评估异质性。
共纳入 906 例患者的 2542 例手术。所有技术的综合结果均显著改善了疼痛、瘀伤、水肿、张力、压痛、美容损伤和总体损伤（均 P<0.00001）。TTL、PAL 和 WAL 显著改善了疼痛减轻（P=0.0005）、瘀伤、肿胀、压痛或美容损伤（均 P<0.05）。然而，WAL 更有效地减轻了张力和总体损伤（均 P<0.005），但这些结果的异质性很高。使用 TTL（1.5%）、PAL（4.0%）、WAL（0%）和同时使用 PAL 和 WAL（2.3%）的研究总体并发症发生率较低。
抽脂技术，包括 TTL、PAL 和 WAL，可显著改善脂肪营养不良患者的症状，且并发症发生率相对较低。WAL 可能会更有效地减轻张力和总体损伤，同时减少并发症；然而，只有一项研究专门采用了这种抽脂方法。据我们所知，这是首个调查脂肪营养不良治疗中抽脂数据的荟萃分析。
