Background:Lymphedema is a debilitating condition that frequently occurs after breast cancer treatment.Vas-cularized lymph node transfer(VLNT)is a promising approach to reduce lymphedema.This study used magnetic reson...Background:Lymphedema is a debilitating condition that frequently occurs after breast cancer treatment.Vas-cularized lymph node transfer(VLNT)is a promising approach to reduce lymphedema.This study used magnetic resonance lymphangiography(MRL)to assess lymphatic reconnections post-VLNT in patients with breast cancer-related lymphedema(BCRL).Methods:The clinical records of six female patients with unilateral upper limb BCRL who underwent VLNT(4 cases)or VLNT combined with breast reconstruction(2 cases)were retrospectively reviewed.All patients were examined using MRL preoperatively and at the 1-year follow-up.The morphological characteristics of the lymphatic network,dermal backflow patterns,and architecture of the lymph nodes were evaluated.Clinical outcomes,patient satisfaction,and complications were assessed.Results:At the 1-year follow-up,reduction in tissue edema and limb circumference was achieved in all six patients.In MRL,the implanted lymph nodes in the axillary region of the affected upper arm were enhanced and visualized in all six patients.Reconnected lymphatic vessels in the subcutaneous tissue associated with the implanted lymph nodes were observed in four patients.Decreased dermal backflow and lymphatic vessel dilation of the affected limbs were observed in all six patients.No disruption of the lymph flow in the donor area was detected.Conclusion:This is the first study to provide direct imaging evidence for the reconnection of afferent lymphatic channels between implanted lymph nodes and the recipient lymphatic system in patients with BCRL.Overall,our study demonstrates the mechanism and efficacy of VLNT in reducing lymphedema.展开更多
BACKGROUND: Secondary lymphedema is one of the common complications after malignant tumor surgery. It is a chronic and complex disease. Once lymphedema occurs, there will be discomfort such as limb swelling, pain, num...BACKGROUND: Secondary lymphedema is one of the common complications after malignant tumor surgery. It is a chronic and complex disease. Once lymphedema occurs, there will be discomfort such as limb swelling, pain, numbness and tension, which will eventually lead to changes in the appearance of the affected limb and will seriously affect the quality of life and require lifelong treatment and psychosocial support. This study investigated the current situation of stigma and alexithymia in patients with lymphedema, and discussed the impact of alexithymia on stigma in patients with lymphedema. AIMS: To understand the current situation of stigma and alexithymia in patients with lymphedema, and to analyze the influence of alexithymia on stigma. METHODS: 195 patients with lymphedema in a hospital were selected by convenient sampling. General information questionnaire, Toronto Alexithymia Scale and social impact scale were used to investigate respectively, to study the general situation, stigma and alexithymia of the respondents. RESULTS: The results showed that the total score of stigma in 195 patients with lymphedema was (60.36 ± 11.08), and the total score of alexithymia was (56.53 ± 8.43). Multiple linear regression analysis showed that alexithymia and family relationship were the influencing factors of stigma in patients with lymphedema. CONCLUSIONS: The patients with lymphedema have obvious stigma, and alexithymia and family relationship are the influencing factors.展开更多
基金supported by the National Natural Science Foundation of China(grant nos.81372080 and 82302822)Shanghai Municipal Key Clinical Specialty(grant no.shslczdzk00901)Shanghai Sailing Program(grant no.21YF1424000).
文摘Background:Lymphedema is a debilitating condition that frequently occurs after breast cancer treatment.Vas-cularized lymph node transfer(VLNT)is a promising approach to reduce lymphedema.This study used magnetic resonance lymphangiography(MRL)to assess lymphatic reconnections post-VLNT in patients with breast cancer-related lymphedema(BCRL).Methods:The clinical records of six female patients with unilateral upper limb BCRL who underwent VLNT(4 cases)or VLNT combined with breast reconstruction(2 cases)were retrospectively reviewed.All patients were examined using MRL preoperatively and at the 1-year follow-up.The morphological characteristics of the lymphatic network,dermal backflow patterns,and architecture of the lymph nodes were evaluated.Clinical outcomes,patient satisfaction,and complications were assessed.Results:At the 1-year follow-up,reduction in tissue edema and limb circumference was achieved in all six patients.In MRL,the implanted lymph nodes in the axillary region of the affected upper arm were enhanced and visualized in all six patients.Reconnected lymphatic vessels in the subcutaneous tissue associated with the implanted lymph nodes were observed in four patients.Decreased dermal backflow and lymphatic vessel dilation of the affected limbs were observed in all six patients.No disruption of the lymph flow in the donor area was detected.Conclusion:This is the first study to provide direct imaging evidence for the reconnection of afferent lymphatic channels between implanted lymph nodes and the recipient lymphatic system in patients with BCRL.Overall,our study demonstrates the mechanism and efficacy of VLNT in reducing lymphedema.
文摘BACKGROUND: Secondary lymphedema is one of the common complications after malignant tumor surgery. It is a chronic and complex disease. Once lymphedema occurs, there will be discomfort such as limb swelling, pain, numbness and tension, which will eventually lead to changes in the appearance of the affected limb and will seriously affect the quality of life and require lifelong treatment and psychosocial support. This study investigated the current situation of stigma and alexithymia in patients with lymphedema, and discussed the impact of alexithymia on stigma in patients with lymphedema. AIMS: To understand the current situation of stigma and alexithymia in patients with lymphedema, and to analyze the influence of alexithymia on stigma. METHODS: 195 patients with lymphedema in a hospital were selected by convenient sampling. General information questionnaire, Toronto Alexithymia Scale and social impact scale were used to investigate respectively, to study the general situation, stigma and alexithymia of the respondents. RESULTS: The results showed that the total score of stigma in 195 patients with lymphedema was (60.36 ± 11.08), and the total score of alexithymia was (56.53 ± 8.43). Multiple linear regression analysis showed that alexithymia and family relationship were the influencing factors of stigma in patients with lymphedema. CONCLUSIONS: The patients with lymphedema have obvious stigma, and alexithymia and family relationship are the influencing factors.