Surgical Prevention of Arm Lymphedema After Breast Cancer Treatment

被引:122
作者
Boccardo, Francesco M. [1 ]
Casabona, Federico [2 ]
Friedman, Daniele [3 ]
Puglisi, Maria [3 ]
De Cian, Franco [4 ]
Ansaldi, Filippo [5 ]
Campisi, Corradino [1 ]
机构
[1] Univ Genoa, S Martino Hosp, Dept Surg, Unit Lymphat Surg, Genoa, Italy
[2] Univ Genoa, S Martino Hosp, Dept Obstet & Gynecol, Genoa, Italy
[3] Univ Genoa, S Martino Hosp, Dept Surg, Breast Unit, Genoa, Italy
[4] Univ Genoa, S Martino Hosp, Dept Surg, Unit Oncol Surg, Genoa, Italy
[5] Univ Genoa, S Martino Hosp, Dept Hlth Sci & Stat, Genoa, Italy
关键词
NODE DISSECTION; LYMPHOSCINTIGRAPHY; PREDICTORS; SEVERITY;
D O I
10.1245/s10434-011-1624-4
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
To prospectively assess the efficacy of the lymphatic microsurgical preventive healing approach (LYMPHA) to prevent lymphedema after axillary dissection (AD) for breast cancer treatment. Among 49 consecutive women referred from March 2008 to September 2009 to undergo complete AD, 46 were randomly divided in 2 groups. Twenty-three underwent the LYMPHA technique for the prevention of arm lymphedema. The other 23 patients had no preventive surgical approach (control group). The LYMPHA procedure consisted of performing lymphatic-venous anastomoses (LVA) at the time of AD. All patients underwent preoperative lymphoscintigraphy (LS). Patients were followed up clinically at 1, 3, 6, 12, and 18 months by volumetry. Postoperatively, LS was performed after 18 months in 41 patients (21 treatment group and 20 control group). Arm volume and LS alterations were assessed. Lymphedema appeared in 1 patient in the treatment group 6 months after surgery (4.34%). In the control group, lymphedema occurred in 7 patients (30.43%). No statistically significant differences in the arm volume were observed in the treatment group during follow-up, while the arm volume in the control group showed a significant increase after 1, 3, and 6 months from operation. There was significant difference between the 2 groups in the volume changes with respect to baseline after 1, 3, 6, 12, and 18 months after surgery (every timing P value < 0.01). LYMPHA represents a valid technique for primary prevention of secondary arm lymphedema with no risk of leaving undetected malignant disease in the axilla.
引用
收藏
页码:2500 / 2505
页数:6
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