PDF(Pubmed)
Abstract：
UNASSIGNED: Breast cancer therapy is a common cause of lymphedema, a chronic condition resulting from impaired fluid drainage through the lymphatic system. The accumulation of fluid in the affected limb leads to swelling, inflammation, and fibrosis, causing irreversible changes. While conservative therapy is the initial treatment for lymphedema, it may prove ineffective for advanced-stage cases that require surgical intervention. Physiological approaches such as lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT) aim to restore lymphatic circulation, while reductive approaches such as excision of excess tissue and liposuction (LS) aim to eliminate fibrofatty tissue. In advanced stages of breast cancer-related lymphedema, a treatment that incorporates both physiological and reductive methods is advantageous. The timing of these approaches varies, and recent simultaneous procedures have been introduced to address both aspects in one surgery. Additionally, lymphedema treatment can be combined with breast reconstruction. Current imaging techniques provide a better assessment of the lymphedematous limb, aiding in the tailoring of a personalized combined approach within a single surgery. This study aims to review the combined approach for breast cancer-related lymphedema treatment and propose a new therapeutic algorithm based on recent literature. The research aims to optimize the management of breast cancer-related lymphedema and improve patient outcomes.
UNASSIGNED: PubMed/MEDLINE was used as the database to conduct a review of the currently available literature concerning combined surgical techniques for treating breast cancer related lymphedema (BCRL).
UNASSIGNED: In our review, we discuss imaging methods for assessing lymphatic system anatomy and function in surgical preparation and decision-making. Simultaneously, we examine a range of combined surgical techniques for treating BCRL, encompassing the combined physiologic approach, breast reconstruction with physiologic surgery, and the combination of reductive and physiologic procedures. Our emphasis remains on key parameters, including patient demographics, lymphedema staging, procedure types, follow-up duration, and objective limb measurements.
UNASSIGNED: Surgical treatment of BCRL can include several surgical modalities that can be performed simultaneously. Current imaging techniques enable the tailoring of a personalized combined one-stage surgery for BCRL patients.
UNASSIGNED: PubMed/MEDLINE was used as the database to conduct a review of the currently available literature concerning combined surgical techniques for treating breast cancer related lymphedema (BCRL).
UNASSIGNED: In our review, we discuss imaging methods for assessing lymphatic system anatomy and function in surgical preparation and decision-making. Simultaneously, we examine a range of combined surgical techniques for treating BCRL, encompassing the combined physiologic approach, breast reconstruction with physiologic surgery, and the combination of reductive and physiologic procedures. Our emphasis remains on key parameters, including patient demographics, lymphedema staging, procedure types, follow-up duration, and objective limb measurements.
UNASSIGNED: Surgical treatment of BCRL can include several surgical modalities that can be performed simultaneously. Current imaging techniques enable the tailoring of a personalized combined one-stage surgery for BCRL patients.
摘要：
■乳腺癌治疗是淋巴水肿的常见原因，由于淋巴系统的液体引流受损而导致的慢性疾病。患肢中的液体积聚导致肿胀，炎症,和纤维化，造成不可逆的变化。虽然保守治疗是淋巴水肿的初始治疗，对于需要手术干预的晚期病例，它可能被证明是无效的。淋巴静脉吻合术（LVA）和血管化淋巴结转移术（VLNT）等生理方法旨在恢复淋巴循环。而诸如切除多余组织和吸脂术（LS）之类的还原性方法旨在消除纤维脂肪组织。在乳腺癌相关淋巴水肿的晚期阶段，结合生理和还原方法的治疗是有利的。这些方法的时机各不相同，和最近的同时程序已经被引入，以解决在一个手术的两个方面。此外,淋巴水肿的治疗可以与乳房重建相结合。当前的成像技术可以更好地评估淋巴水肿肢体，帮助在单个手术中定制个性化的组合方法。本研究旨在回顾乳腺癌相关淋巴水肿的联合治疗方法，并根据最近的文献提出一种新的治疗算法。该研究旨在优化乳腺癌相关淋巴水肿的管理并改善患者预后。
■使用PubMed/MEDLINE作为数据库，对目前可用的有关联合手术技术治疗乳腺癌相关淋巴水肿（BCRL）的文献进行综述。
■在我们的评论中，我们讨论了在手术准备和决策中评估淋巴系统解剖结构和功能的影像学方法。同时,我们研究了一系列治疗BCRL的联合手术技术，包括结合的生理方法，生理手术乳房重建，还原和生理程序的结合。我们的重点仍然是关键参数，包括病人的人口统计,淋巴水肿分期,程序类型,随访持续时间,和客观的肢体测量。
■BCRL的手术治疗可以包括几种可以同时进行的手术方式。当前的成像技术能够为BCRL患者定制个性化的联合一期手术。
■使用PubMed/MEDLINE作为数据库，对目前可用的有关联合手术技术治疗乳腺癌相关淋巴水肿（BCRL）的文献进行综述。
■在我们的评论中，我们讨论了在手术准备和决策中评估淋巴系统解剖结构和功能的影像学方法。同时,我们研究了一系列治疗BCRL的联合手术技术，包括结合的生理方法，生理手术乳房重建，还原和生理程序的结合。我们的重点仍然是关键参数，包括病人的人口统计,淋巴水肿分期,程序类型,随访持续时间,和客观的肢体测量。
■BCRL的手术治疗可以包括几种可以同时进行的手术方式。当前的成像技术能够为BCRL患者定制个性化的联合一期手术。
