Surgery for Lymphedema Prevention and Treatment

Karla C. Maita,Francisco R. Avila, Ricardo A. Torres-Guzman,John P. Garcia,Sahar Borna, Sally A. Brown, Olivia A. Ho,Antonio J. Forte

Current Breast Cancer Reports(2024)

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摘要
This review explores the evidence surrounding the efficacy of preventing and treating lymphedema through surgical means. Sentinel Lymph Node Biopsy (SLNB) has significantly reduced the need for axillary lymph node dissection (ALND), decreasing lymphedema rates. Axillary Reverse Mapping (ARM) techniques offer the opportunity to identify and preserve lymphatics during surgery. Immediate lymphatic reconstruction through lymphatic or lymphatic venous anastomosis and free lymph node transfer attempt to maintain continued post-operative lymphatic flow, further mitigating BCRL risks and optimizing patient outcomes. A growing body of data is evaluating surgical techniques for lymphedema prevention and treatment. Improvements in patients’ quality of life have been reported with these techniques. Further research should focus on randomized controlled trials and prospective studies to investigate patient indications, technique selection, long-term durability, and personalized patient strategies.
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关键词
Breast Cancer-Related Lymphedema,Lymphedema Prevention,Lymphedema Surgery,Lymphovenous Anastomoses,Axillary Reverse Mapping,Immediate Lymphatic Reconstruction
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