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治疗乳腺癌相关淋巴的痕减压:这是必要的吗?
Emily R Finkelstein1, Dylan Treger1, Aziz Shittu1
1Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
Journal of reconstructive microsurgery
|July 23, 2024
概括
在与乳腺癌相关的淋巴 (BCRL) 手术中,痕减压可能是不必要的. 大多数患者没有表现出静脉狭窄,而那些经历了血管化的淋巴结转移而没有痕释放的患者取得了成功的结果,减少了手术时间和风险.
科学领域:
- 血管外科 血管外科
- 淋巴 edem 管理 淋巴 edem 管理
- 在瘤学瘤学.
背景情况:
- 乳腺癌的治疗方法,如乳腺切除术和淋巴结解剖,可能会导致痕.
- 这种痕可能导致受影响四肢的静脉狭窄和高血压.
- 当前的外科实践往往包括在淋巴瘤手术中释放痕,但其必要性尚未得到证实.
研究的目的:
- 为了确定与乳腺癌相关的淋巴结胀 (BCRL) 患者的功能性静脉狭窄的患病率.
- 评估痕减压是否是生理淋巴瘤手术的必需组成部分.
主要方法:
- 在2020年1月至2022年10月期间接受单边BCRL治疗的64名患者的回顾性审查.
- 双重静脉超声检查双边上肢,以确定静脉流动障碍和静脉狭窄.
- 对接受血管化淋巴结转移 (VLNT) 患者的手术结果进行分析,包括或不包括伤减压.
主要成果:
- 在完成超声波的47名患者中,只有1人 (2%) 显示静脉狭窄可能与痕相关.
- 六名患者 (9%) 接受了无痕减压的VLNT,并经历了成功的结果.
- 观察到淋巴瘤生命影响量表和淋巴瘤指数得分显著下降.
结论:
- 在BCRL患者中,功能性静脉狭窄不常见,大多数患者没有超声波证据.
- 没有痕减压的VLNT似乎有效治疗BCRL.
- 消除痕减压可以缩短手术时间,并减少股神经血管结构的风险.
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