Demmer Wolfram, Hock Louisa Antonie, Koban Konstantin Christoph, Wiggenhauser Paul Severin, Brendel Matthias, Giunta Riccardo, Nürnberger Tim
Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, 80539 Munich, Germany.
Department of Nuclear Medicine, Ludwig-Maximilians-University, 81377 Munich, Germany.
Life (Basel). 2025 Jun 4;15(6):914. doi: 10.3390/life15060914.
This study investigates long-term volume reduction after microsurgical autologous lymphatic vessel transplantation (LVT) in patients with chronic lymphoedema. Lymphoedema is caused by inadequate lymphatic drainage and leads to swelling, pain, and a reduced quality of life. Conservative treatments often show only limited success, which is why surgical procedures such as LVT are increasingly gaining in importance. In a retrospective long-term analysis, patients who underwent LVT between 1988 and 2010 were examined on average 21.7 years after surgery. The examination included pre- and post-operative volume measurements, which were supplemented by modern 3D body scanner analyses and lymphoscintigraphy. The results show a significant volume reduction both in the short term ( < 0.01) and at the follow-up examination ( = 0.04). There was no significant difference between manual volumetry with circumferential measurements and 3D volumetry ( = 0.775). The improvement in lymph transport capacity was considerable ( = 0.078). This study provides valuable insights for the further development of lymphatic surgery. While preferred surgical methods change over time, this study demonstrates that LVT can make a decisive contribution to improving the quality of life of lymphedema patients.
本研究调查了慢性淋巴水肿患者接受显微外科自体淋巴管移植(LVT)后的长期体积减小情况。淋巴水肿是由淋巴引流不足引起的,会导致肿胀、疼痛和生活质量下降。保守治疗往往效果有限,这就是为什么诸如LVT等外科手术越来越重要的原因。在一项回顾性长期分析中,对1988年至2010年间接受LVT的患者在术后平均21.7年进行了检查。检查包括术前和术后的体积测量,并辅以现代3D身体扫描仪分析和淋巴闪烁造影。结果显示,短期内(<0.01)和随访检查时(=0.04)体积均有显著减小。周向测量的手动容积法与3D容积法之间无显著差异(=0.775)。淋巴运输能力有相当大的改善(=0.078)。本研究为淋巴外科的进一步发展提供了有价值的见解。虽然首选的手术方法会随时间变化,但本研究表明LVT可为改善淋巴水肿患者的生活质量做出决定性贡献。