背景:脂肪水肿是一种相对常见的,经常误诊,当保守治疗失败时,通常使用吸脂术治疗的慢性疾病。技术,如传统的肿胀吸脂术(TTL),动力辅助吸脂术(PAL),喷水辅助吸脂术(WAL)是流行的外科手术,尽管目前尚不清楚这些技术的比较。这项荟萃分析旨在评估脂肪水肿患者吸脂术的疗效和安全性。
方法:确定了2003年1月至2023年4月发表在PubMed上的相关英文脂膜研究。纳入了10篇具有术后结局和并发症数据的文章(2篇TTL,5PAL,1WAL,和2篇文章使用PAL和WAL)。结果采用描述性统计进行总结,并使用随机效应模型评估异质性。
结果:共纳入906例患者的2542例手术。所有技术的综合结果显着改善了疼痛,瘀伤,水肿,紧张,压力灵敏度,化妆品损害,和一般损害(所有P<0.00001)。TTL,PAL,和WAL导致疼痛减轻的显着改善P=0.0005),瘀伤,肿胀,压力灵敏度,或美容损害(均P<0.05)。然而,WAL更有效地减少了张力和全身损伤(所有P<0.005),但这些结果的异质性很高。使用TTL的研究总体并发症发生率较低(1.5%),PAL(4.0%),沃尔玛(0%),以及PAL和WAL(2.3%)。
结论:吸脂技术,包括TTL,PAL,WAL,在并发症发生率相对较低的脂肪水肿患者中,症状得到了显着改善。WAL可能会导致更大幅度的张力减少和全身损伤,并发症更少;然而,只有一项研究专门进行了这种抽脂方法。据我们所知,这是对脂肪水肿治疗中的吸脂术数据进行的首次荟萃分析.
BACKGROUND: Lipedema is a relatively common, frequently misdiagnosed, chronic condition that is often treated using liposuction when conservative therapies fail. Techniques such as traditional tumescent liposuction (TTL), power-assisted liposuction (PAL), and water-jet-assisted liposuction (WAL) are popular surgical interventions, although it is unclear how these techniques compare. This meta-analysis aimed to assess the efficacy and safety of liposuction in patients with lipedema.
METHODS: Relevant English lipedema studies published in PubMed from January 2003 to April 2023 were identified. Ten articles with post-operative outcomes and complications data were included (2 TTL, 5 PAL, 1 WAL, and 2 articles used PAL and WAL). Results were summarized using descriptive statistics, and a randomized effects model was used to evaluate heterogeneity.
RESULTS: A total of 2542 procedures in 906 patients were included. Combined outcomes for all techniques significantly improved pain, bruising, edema, tension, pressure sensitivity, cosmetic impairment, and general impairment (all P < 0.00001). TTL, PAL, and WAL led to significant improvements in pain reduction P = 0.0005), bruising, swelling, pressure sensitivity, or cosmetic impairment (all P < 0.05). However, WAL more effectively reduced tension and general impairment (all P < 0.005), but heterogeneity for these outcomes was high. Overall complication rates were low for the studies that used TTL (1.5%), PAL (4.0%), WAL (0%), and both PAL and WAL (2.3%).
CONCLUSIONS: Liposuction techniques, including TTL, PAL, and WAL, resulted in significant symptom improvement in patients with lipedema with a relatively low complication rate. WAL may potentially result in a more substantial reduction of tension and general impairment with fewer complications; however, only a single study performed this method of liposuction exclusively. To the best of our knowledge, this is the first meta-analysis investigating liposuction data in lipedema treatment.