Aitzetmüller-Klietz Marie-Luise, Ozturk Mahmut, Seefeldt Tobias, Wiebringhaus Philipp, Wellenbrock Sascha Veiz, Tav Baksan, Hirsch Tobias, Harati Kamran, Aitzetmüller-Klietz Matthias
Department of Plastic Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany.
Department for Plastic and Reconstructive Surgery, Institute for Musculoskeletal Medicine, Westfaelische Wilhelms-University Muenster, 48149 Münster, Germany.
J Clin Med. 2025 Jan 6;14(1):279. doi: 10.3390/jcm14010279.
: Despite its estimated high prevalence among women and increasing awareness, lipedema remains under-investigated. Ignoring its debilitating nature, surgical treatment for this condition is frequently covered by health insurance only in advanced stages and after the exhaustion of conservative therapies. : A total of 1015 patients with lipedema were recruited via social media platforms. Of these, 860 patients provided answers to at least one complete section of the modified Body-Q questionnaire (response rate 85%). The Mann-Whitney U and Kruskal-Wallis tests were utilized to assess the impact of the surgical treatment by means of patient-reported outcomes on the self-perception of various body areas. : The satisfaction scores among conservatively treated patients for abdominal appearance, arms, back, body, buttocks, and inner thighs showed a statistically significant decline with increasing stages of lipedema. The comparison of patient evaluation scores in the appearance domain demonstrated better patient self-perception scores in patients who received at least one session of the surgical treatment for the hips and thighs ( < 0.01), inner thighs ( < 0.01), and excess skin (0.01) scales. On the body scale, the patients who underwent liposuction again reported better satisfaction scores; however, this did not reach statistical significance ( < 0.081). In the health-related quality of life domain, the patients who received liposuction treatment reported a better outcome in the body image ( < 0.01), physical function ( = 0.05), physical symptoms ( = 0.04), and psychological function ( < 0.01) scales. : The current study underscores the burden of lipedema of affected patients and its negative impact on self-perception. As the disease progresses, conservatively treated patients experience a decline in satisfaction with various aspects of their appearance. However, surgical interventions, particularly liposuction, does not address esthetic concerns but significantly improve health-related quality of life across multiple domains, emphasizing the comprehensive benefits of surgical intervention in the management of lipedema.
尽管据估计脂性水肿在女性中患病率很高且人们的认识不断提高，但对其研究仍不足。由于忽视了其使人衰弱的特性，这种疾病的手术治疗通常只有在晚期且保守治疗无效后才会被医疗保险覆盖。
通过社交媒体平台招募了总共1015例脂性水肿患者。其中，860例患者至少对改良的身体问卷（Body-Q）的一个完整部分提供了答案（回复率85%）。采用曼-惠特尼U检验和克鲁斯卡尔-沃利斯检验，通过患者报告的结果来评估手术治疗对各个身体部位自我认知的影响。
保守治疗患者对腹部外观、手臂、背部、身体、臀部和大腿内侧的满意度得分随着脂性水肿阶段的增加而出现统计学显著下降。在外观领域患者评估得分的比较显示，接受过至少一次臀部和大腿、大腿内侧以及多余皮肤手术治疗的患者自我认知得分更高（<0.01）。在身体方面，接受抽脂手术的患者再次报告了更高的满意度得分；然而，这未达到统计学显著性（<0.081）。在与健康相关的生活质量领域，接受抽脂治疗的患者在身体形象（<0.01）、身体功能（=0.05）、身体症状（=0.04）和心理功能（<0.01）方面的得分更高。
当前研究强调了脂性水肿给患者带来的负担及其对自我认知的负面影响。随着疾病进展，保守治疗的患者对自身外观各个方面的满意度下降。然而，手术干预，尤其是抽脂手术，虽然不能解决美学问题，但能显著改善多个领域与健康相关的生活质量，强调了手术干预在脂性水肿管理中的综合益处。
