Lymphaticovenular Bypass for Lymphedema Management in Breast Cancer Patients: A Prospective Study
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Auteurs : David W. Chang [États-Unis]Source :
- Plastic and reconstructive surgery : (1963) [ 0032-1052 ] ; 2010.
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Abstract
Background: Lymphedema is a common and debilitating condition. Management options for lymphedema are limited and controversial. The purpose of this prospective study was to provide a preliminary analysis of lymphaticovenular bypass for the treatment of upper limb lymphedema in breast cancer patients. Methods: Twenty patients with upper extremity lymphedema secondary to treatment of breast cancer underwent lymphaticovenular bypass using a "supermicrosurgical" approach. The mean age of the patients was 54 years, 16 patients had received preoperative radiation therapy, and all patients had received axillary lymph node dissection. The mean duration of lymphedema was 4.8 years, and the mean volume differential of the lymphedematous arm compared with the unaffected arm was 34 percent. Evaluation included qualitative assessment and quantitative volumetric analysis before surgery and at 1 month, 3 months, 6 months, and 1 year after the procedure. Results: The mean number of bypasses performed per patient was 3.5 (range, two to five), and the size of bypasses ranged from 0.3 to 0.8 mm. The mean operative time was 3.3 hours (range, 2 to 5 hours). Hospital stay was less than 24 hours for all patients. The mean follow-up time was 18 months. Nineteen patients (95 percent) reported symptom improvement following surgery, and 13 patients had quantitative improvement. The mean volume differential reduction was 29 percent at 1 month, 36 percent at 3 months, 39 percent at 6 months, and 35 percent at 1 year. No patients experienced postoperative complications or lymphedema exacerbation. Conclusions: Lymphaticovenular bypass may effectively reduce the severity of lymphedema in breast cancer patients. Long-term analysis is needed.
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Anderson Cancer Center</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">10-0403998</idno><date when="2010">2010</date><idno type="stanalyst">PASCAL 10-0403998 INIST</idno><idno type="RBID">Pascal:10-0403998</idno><idno type="wicri:Area/PascalFrancis/Corpus">000235</idno><idno type="wicri:Area/PascalFrancis/Curation">000723</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000247</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000247</idno><idno type="wicri:doubleKey">0032-1052:2010:Chang D:lymphaticovenular:bypass:for</idno><idno type="wicri:Area/Main/Merge">005F41</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Lymphaticovenular Bypass for Lymphedema Management in Breast Cancer Patients: A Prospective Study</title><author><name sortKey="Chang, David W" sort="Chang, David W" uniqKey="Chang D" first="David W." last="Chang">David W. Chang</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center</s1><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Plastic and reconstructive surgery : (1963)</title><title level="j" type="abbreviated">Plast. reconstr. surg. : (1963)</title><idno type="ISSN">0032-1052</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Plastic and reconstructive surgery : (1963)</title><title level="j" type="abbreviated">Plast. reconstr. surg. : (1963)</title><idno type="ISSN">0032-1052</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Breast cancer</term><term>Bypass</term><term>Clinical management</term><term>Human</term><term>Lymphedema</term><term>Surgery</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Lymphoedème</term><term>Cancer du sein</term><term>Dérivation</term><term>Traitement</term><term>Chirurgie</term><term>Conduite à tenir</term><term>Homme</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Lymphedema is a common and debilitating condition. Management options for lymphedema are limited and controversial. The purpose of this prospective study was to provide a preliminary analysis of lymphaticovenular bypass for the treatment of upper limb lymphedema in breast cancer patients. Methods: Twenty patients with upper extremity lymphedema secondary to treatment of breast cancer underwent lymphaticovenular bypass using a "supermicrosurgical" approach. The mean age of the patients was 54 years, 16 patients had received preoperative radiation therapy, and all patients had received axillary lymph node dissection. The mean duration of lymphedema was 4.8 years, and the mean volume differential of the lymphedematous arm compared with the unaffected arm was 34 percent. Evaluation included qualitative assessment and quantitative volumetric analysis before surgery and at 1 month, 3 months, 6 months, and 1 year after the procedure. Results: The mean number of bypasses performed per patient was 3.5 (range, two to five), and the size of bypasses ranged from 0.3 to 0.8 mm. The mean operative time was 3.3 hours (range, 2 to 5 hours). Hospital stay was less than 24 hours for all patients. The mean follow-up time was 18 months. Nineteen patients (95 percent) reported symptom improvement following surgery, and 13 patients had quantitative improvement. The mean volume differential reduction was 29 percent at 1 month, 36 percent at 3 months, 39 percent at 6 months, and 35 percent at 1 year. No patients experienced postoperative complications or lymphedema exacerbation. Conclusions: Lymphaticovenular bypass may effectively reduce the severity of lymphedema in breast cancer patients. Long-term analysis is needed.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country></list><tree><country name="États-Unis"><noRegion><name sortKey="Chang, David W" sort="Chang, David W" uniqKey="Chang D" first="David W." last="Chang">David W. Chang</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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