[TREATMENT OF POST-MASTECTOMY UPPER LIMB LYMPHEDEMA BY MODIFIED SIDE-TO-END LYMPHATICOVENULAR ANASTOMOSIS].

Abstract

OBJECTIVE:

To investigate the therapeutic effect of modified side-to-end lymphaticovenular anastomosis in the treatment of post-mastectomy upper limb lymphedema.

METHODS:

Between May 2010 and May 2011, 11 female patients with post-mastectomy upper limb lymphedema underwent a modified side-to-end lymphaticovenular anastomosis. The average age was 49.5 years (range, 38-55 years). Lymphedema occurred at 7-30 months (mean, 18.3 months) after resection of breast cancer, with an average disease duration of 25.5 months (range, 10-38 months). The left upper limb was involved in 5 cases and the right upper limb in 6 cases. In accordance with difference value between health and affected sides criteria, 5 cases were rated as moderate, and 6 cases as severe.

RESULTS:

Modified side-to-end lymphaticovenular anastomosis was successfully completed in all patients. Primary healing of incision was obtained in the other patients except 1 case of delayed healing. All patients were followed up for an average of 38.4 months (range, 36-40 months). Limb pain and swelling were relieved; no episodic attack or recurrence was observed. The circumference of affected upper arm was significantly decreased from preoperative (33.9 ± 3.7) cm to postoperative (31.0 ± 3.5) cm at 6 months and (30.9 ± 3.5) cm at 36 months (P < 0.05), but no significant difference was found between at 3 and 6 months (P > 0.05); the circumference of affected forearm was significantly decreased from preoperative (30.1 ± 3.6) cm to postoperative (27.8 ± 3.4) cm at 6 months and (27.7 ± 3.3) cm at 36 months (P < 0.05), but no significant difference was shown between at 6 and 36 months (P > 0.05). According to Campis evaluation standard to assess efficacy, the results were excellent in 3 cases, good in 6 cases, and improved in 2 cases

CONCLUSIO:

n Using modified side-to-end lymphaticovenular anastomosis may be effective in the treatment of upper limb lymphedema after mastectomy.

• Authors: Pengju Shi, Wenlong Zhang, Gang Zhao, Liang Li, Cai Haifeng
• Journal: Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery (Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi) Vol. 29 Issue 3 Pg. 339-42 (Mar 2015) ISSN: 1002-1892 [Print] China
• PMID: 26455202 (Publication Type: Journal Article)

Topics

• Adult
• Anastomosis, Surgical (methods)
• Arm (blood supply, surgery)
• Breast Neoplasms (surgery)
• Female
• Humans
• Lymphatic Vessels (blood supply, surgery)
• Lymphedema (etiology, physiopathology, surgery)
• Mastectomy (adverse effects)
• Microsurgery
• Middle Aged
• Neoplasm Recurrence, Local
• Postoperative Complications
• Treatment Outcome
• Vascular Surgical Procedures