Autologous tissue breast reconstructionand thoracic wall repair with microsurgical lymph node transfers and lymphatic-venous anastomoses for the treatment of mastectomy related axillary cavity deformation and upper extremity lymphedema
10.3760/cma.j.issn.1009-4598.2017.s1.012
- VernacularTitle:自体组织乳房再造及胸壁修复同期行吻合血管淋巴结组织移植及淋巴管静脉吻合治疗乳腺癌术后腋窝凹陷畸形及上肢淋巴水肿
- Author:
Lan MU
1
;
Ye BI
;
Zhe PENG
;
Guangxue LI
;
Yan LIU
;
Kai YANG
;
Shu WANG
;
Nan HONG
;
Qian WANG
;
Jie LUAN
;
Dali MU
;
Minqiang XIN
;
Yuanbo LIU
;
Lixue XUAN
;
Ming LI
;
Xiaojie ZHONG
;
Huangfu WU
;
Liping ZHENG
;
Zhuangqing YANG
;
Fenghua ZHANG
;
Xinmei XIU
Author Information
1. 100044,北京大学人民医院整形外科医疗美容科
- Keywords:
autologous tissue breast reconstruction;
lymph node transfer,lymphatic-venous anastomoses;
lymphedema
- From:
Chinese Journal of Plastic Surgery
2017;33(z1):54-60
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of autologous tissue breast reconstruction with microsurgical lymph node transfers and lymphatic-venous anastomoses for the treatment of mastectomy related axillary cavitydeformation and upper extremity lymphedema .Methods The donor sites of lymph node transfers were mainly chosen according to the donor site of breast reconstruction .Themicrosurgical lymph nodes were transferred to the axillary cavity .When the superficial lymph vessels could be detected in lymphangiography with indocyanine green , thelymphatic-venous anastomoses were done to improve the lymphatic drainage .The treatment effect was assessed by the perimeter changes of different parts of upper extremity, the isotope lymphangiography and associated symptoms . Results 20 cases involved in autologous tissue breast reconstruction with microsurgical lymph node transfers , 18 cases from ingruinallymph nodes and 2 cases from lateral thoracic lymph nodes .2 cases receivedlymphatic-venous anastomoses on their upper extremity .The perimeters of palm and wrist were found significantly decreased in 6 months postoperation , while the perimeters of midpoint forearm and upper arm also decreased .The cellulitis, pain and swell happened less during the follow-up from 6 months up to 4 years. The postoperation isotope lymphangiography showed functional transferred lymph nodes inaxillary cavity , better lymphatic drainage and less volume of upper extremity .The subcutaneous superficial lymphatic drainage signs could be observed by the isotope lymphangiography in cases who had lymphatic -venous anastomoseson upper extremity .Conclusions Autologous tissue breast reconstruction with microsurgical lymph node transfers and lymphatic-venous anastomoses is a promising option for the treatment of mastectomy related axillary cavitydeformation and upper extremity lymphedema .The long term results need longer follow-up and more research .
