抽吸减容术治疗乳腺癌术后上肢淋巴水肿

Effect of debulking surgery on upper limb lymphedema after breast cancer surgery

目的探索抽吸减容术治疗不同程度乳腺癌术后上肢淋巴水肿的效果。方法回顾性分析2020年1月至2022年12月就诊的42例乳腺癌术后上肢淋巴水肿患者的临床资料。患者均为女性,年龄(57.19±8.79)岁;根据严重程度分为非重度组(25例)和重度组(17例),分析不同程度患者的临床特征,以及抽吸减容术治疗的效果。结果非重度组平均年龄为(54.6±8.85)岁,重度组平均年龄为(61.0±7.39)岁,差异有统计学意义(P=0.019)。术前非重度组BMI为(26.58±3.64)kg/m^(2),重度组BMI为(29.11±5.83)kg/m^(2),两组差异无统计学意义(P=0.091)。手术方式上,非重度/重度乳腺癌术后上肢淋巴水肿患者行淋巴水肿抽吸术,而少数极重度乳腺癌术后上肢淋巴水肿行淋巴水肿抽吸术联合病变组织切除术。非重度组与重度组相比,手术时间、注入膨胀液量、吸出脂肪悬浊液量、吸脂量、术中出血量均有统计学差异(P<0.01)。两组术毕及术后3个月肿胀程度均有明显改善(P<0.01),非重度组术毕及术后3个月的肿胀改善程度明显优于重度组,差异具有统计学意义(P<0.01)。结论抽吸减容术可以明显改善不同严重程度的乳腺癌术后上肢淋巴水肿。

Objective To explore the effect of suction volume reduction surgery in the treatment of upper limb lymphedema after breast cancer surgery with different severity.Methods The clinical data of 42 patients with upper limb lymphedema after breast cancer surgery from January 2020 to December 2022 were retrospectively analyzed,including 42 women aged(57.19±8.79)years.According to the severity,the patients were divided into non-severe group(n=25)and severe group(n=17).The clinical characteristics of patients with upper limb lymphedema after breast cancer surgery of different severity were analyzed,and the application effect of suction volume reduction surgery on upper limb lymphedema after breast cancer surgery of different severity was analyzed.Results The average age of the non-severe group was(54.6±8.85)years old,while the average age of the severe group was(61.0±7.39)years old,with a statistically significant difference(P=0.019).The preoperative BMI of the non-severe group was(26.58±3.64)kg/m^(2),while the BMI of the severe group was(29.11±5.83)kg/m^(2),with no statistically significant difference between the two groups(P=0.091).In terms of operation mode,lymphedema aspiration was performed for patients with non-severe/severe upper limb lymphedema after operation of breast cancer,while a few patients with extremely severe upper limb lymphedema were treated with lymphedema aspiration combined with pathological tissue resection.Compared with the severe group,the surgery time,injection volume of swelling fluid,suction volume of fat suspension,liposuction volume,and intraoperative bleeding volume in the non-severe group had statistical differences(P<0.01).The swelling degree of the two groups was improved after operation and 3 months after operation(P<0.01),and the swelling improvement degree of the non-severe group was significantly better than that of the severe group after operation and 3 months after operation,the difference was statistically significant(P<0.01).Conclusion Aspiration volume reduction surgery can significantly improve the degree of limb swelling of upper limb lymphedema after breast cancer surgery of different severity.