■淋巴水肿是淋巴结手术的常见并发症;然而,诊断的证据,监测,治疗的条件是稀疏的。这项荟萃分析评估了淋巴水肿的常见外科治疗的结果,并为未来的研究方向提供了建议。
■根据系统评价和荟萃分析(PRISMA)指南的首选报告项目对PubMed和Embase进行审查。截至2020年6月1日发表的所有英语语言研究都包括在内。我们排除了非手术干预,文献综述,信件,评论,非人类或尸体研究,和样本量不足的研究(N<20)。
■来自15项淋巴水肿患者研究的583例符合我们单臂荟萃分析的纳入标准:387例上肢治疗和196例下肢治疗。上肢和下肢淋巴水肿的体积减少率为38.0%[95%置信区间(CI),25.9%-50.2%]和49.5%(95%CI,32.6%-66.3%),分别。术后最常见的并发症是蜂窝织炎,4.5%的患者报告(95%CI,0.9%-10.6%),和血清,4.6%(95%CI,0%-17.8%)的患者报告。在所有研究中,接受上肢治疗的患者的平均生活质量指标提高了52.2%(95%CI,25.1%-79.2%)。
■淋巴水肿的外科治疗显示出巨大的希望。我们的数据表明,采用标准化的肢体测量和疾病分期系统可以提高治疗结果的有效性。
UNASSIGNED: Lymphedema is a common complication of lymph node surgery; however, evidence on diagnosing, monitoring, and treating the condition is sparse. This meta-analysis evaluates the outcomes of common surgical treatments of lymphedema and provides suggestions for future research directions.
UNASSIGNED: A review of PubMed and Embase was performed according to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. All English-language studies published through June 1, 2020, were included. We excluded nonsurgical interventions, literature reviews, letters, commentaries, nonhuman or cadaver studies, and studies with inadequate sample size (N < 20).
UNASSIGNED: A total of 583 cases from 15 studies in patients with lymphedema met our inclusion criteria for our 1-arm meta-analysis: 387 upper extremity treatments and 196 lower extremity treatments. The volume reduction rates of lymphedema for upper extremity and lower extremity treatments were 38.0% [95% confidence interval (CI), 25.9%-50.2%] and 49.5% (95% CI, 32.6%-66.3%), respectively. The most common postoperative complications were cellulitis, reported in 4.5% of patients (95% CI, 0.9%-10.6%), and seromas, reported in 4.6% (95% CI, 0%-17.8%) of patients. Average quality of life measures across all studies improved by 52.2% (95% CI, 25.1%-79.2%) for patients who underwent upper extremity treatment.
UNASSIGNED: Surgical management of lymphedema shows great promise. Our data suggest that adopting a standardized system of limb measurement and disease staging can increase effectiveness of treatment outcomes.