超显微微静脉-淋巴管吻合治疗乳腺癌术后上肢淋巴水肿  

Breast cancer related lymphedema treated by super-microsurgery

作　　者：李珺[1] 陈威帆 曾伟峰[3] 赵海东[1] 

机构地区：[1]大连医科大学附属第二医院乳腺外科 [2]美国爱荷华大学临床医疗中心整形与修复外科 [3]大连医科大学附属第二医院手足外科

出　　处：《中华内分泌外科杂志》2015年第5期360-363,共4页Chinese Journal of Endocrine Surgery

摘　　要：目的：上肢淋巴水肿是乳腺癌手术的严重并发症之一，其治疗一直是困扰众多乳腺外科医生的难题。本文利用超显微手术技术，探讨微静脉-淋巴管吻合技术对乳腺癌术后上肢淋巴水肿的治疗效果。方法收集2014年10月至2015年5月大连医科大学附属第二医院收治的乳腺癌术后上肢淋巴水肿的患者8例，行超显微水平微静脉-淋巴管吻合术。结果术中吻合的淋巴管数量平均（12.4±5.0）（7～19）支，手术持续时间范围为3.50～7.75 h，术后平均住院（5.5±3.2） d。此8例手术术中即可看到上肢水肿症状明显改善，术后均有临床获益。结论超显微水平微静脉-淋巴管吻合术可为乳腺癌术后上肢淋巴水肿的患者提供一个安全、有效、外观及预后更佳的手术方式。Objective Lymphedema is a common complication interrupting a large percentage of breast cancer survivors .How to release the breast cancer survivors from the pain of lymphedema remains a question to breast surgeons .The rapid development of the super-microsurgical measurement allows lymphaticovenular anasto-mosis to become a better way to treat breast cancer related lymphedema .Methods We followed a breast cancer related lymphedema case amd offered super-microsurgical lymphaticovenular anastomosis to her .Results The surgery lasted 4.5 h, and contained 11 anastomosis of lymph ducts .Improvement of edema could be seen during the surgery and the measurement of the upper limb became smaller just one day after surgery .Conclusion Su-per-microsurgical lymphaticovenular anastomosis is a safe improvement for extremity lymphedema after mastectomy and it can provide a better prognosis and appearance .

关 键 词：上肢淋巴水肿 超显微手术 微静脉-淋巴管吻合术 

分 类 号：R737.9[医药卫生—肿瘤]