Application of preventive lymphaticovenular anastomosis in breast cancer patients with axillary lymph node dissection based on multidisciplinary collabration

doi:10.3877/cma.j.issn.1673-9450.2024.03.004

Abstract

Abstract:

Objective

To observe the effect of axillary lymph node dissection (ALND) and preventive lymphaticovenular anastomosis (LVA) on postoperative upper limb lymphedema and quality of life in patients with breast cancer based on the multidisciplinary callabration model.

Methods

A total of 17 patients with breast cancer who underwent ALND and preventive LVA admitted to the Department of Breast Surgery of Affiliated Tumor Hospital of Guangxi Medical University from August 2022 to July 2023 were entrolled. By establishing a multidisciplinary team, the medical model of preoperative multi-disciplinary treatment, assisting patient decision-making, postoperative rehabilitation guidance, and internet plus management were implemented. Monitored the circumference of the upper limbs and evaluated the postoperative quality of life using the Chinese version of the WHOQOL-BREF.

Results

The follow-up time was 9.60-19.30 (12.74±2.51) months.The difference in the circumference of upper limbs was 0.50 (0.03, 0.88)cm before surgery and 0.50 (0.13, 1.00)cm at the last follow-up, no limb lymphedema occured after operation. At the last follow-up, the patient′s quality of life score was 15.40±2.37, 16.64±2.19, 14.80±2.66 and 15.43±2.12 in the physiological, psychological, social relations and environmental fields, respectively, and the highest scores was in the psychological fields.

Conclusion

Preventive LVA under the multidisciplinary callabration model can increase the participation of breast cancer patients in treatment decision-making, reduce the occurrence of postoperative lymphedema and improve the quality of life of patients.

Key words: Breast cancer, Lymphaticovenular anastomosis, Lymphedema, Preventative healing approach, Multidisciplinary collaboration

Yan Meng, Rubing Tang, Yi Jiang, Hua Lu, Yulan Su, Qiong Zhang, Yingyu He. Application of preventive lymphaticovenular anastomosis in breast cancer patients with axillary lymph node dissection based on multidisciplinary collabration[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2024, 19(03): 204-207.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhssyxfzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1673-9450.2024.03.004

https://zhssyxfzz.cma-cmc.com.cn/EN/Y2024/V19/I03/204

References 18

[1]	Boughey JC, Suman VJ, Mittendorf EA, et al. Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer: the ACOSOG Z1071 (Alliance) clinical trial[J]. JAMA, 2013, 310(14): 1455-1461.
[2]	Donker M, Van Tienhoven G, Straver M, et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial[J]. Lancet Oncol, 2014, 15(12): 1303-1310.
[3]	Galimberti V, Cole B, Viale G, et al. Axillary dissection versus no axillary dissection in patients with breast cancer and sentinel-node micrometastases (IBCSG 23-01): 10-year follow-up of a randomised, controlled phase 3 trial[J]. Lancet Oncol, 2018, 19(10): 1385-1393.
[4]	Krag DN, Anderson SJ, Julian TB, et al. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial[J]. Lancet Oncol, 2010, 11(10): 927-933.
[5]	Mclaughlin S, Brunelle C, Taghian A. Breast cancer-related lymphedema: risk factors, screening, management, and the impact of locoregional treatment[J]. J Clin Oncol, 2020, 38(20): 2341-2350.
[6]	蒋奕，廖晓明，唐玮，等. 套入式淋巴管静脉吻合在乳腺癌腋窝淋巴结清扫术同期预防性淋巴水肿手术中的应用1例并文献复习[J]. 中国癌症防治杂志，2022, 14(2): 212-215.
[7]	Boccardo F, Casabona F, Friedman D, et al. Surgical prevention of arm lymphedema after breast cancer treatment[J]. Ann Surg Oncol, 2011, 18(9): 2500-2505.
[8]	Feldman S, Bansil H, Ascherman J, et al. Single institution experience with lymphatic microsurgical preventive healing approach (LYMPHA) for the primary prevention of lymphedema[J]. Ann Surg Oncol, 2015, 22(10): 3296-3301.
[9]	程舸畅，唐举玉. 妇科恶性肿瘤根治术后下肢淋巴水肿的外科治疗进展[J]. 中华显微外科杂志，2022, 45(2): 230-235.
[10]	中华护理学会. 乳腺癌术后淋巴水肿预防和护理[EB/OL].(2021-03-13) [2024-03-20]. URL
[11]	何英煜，蒙燕，李繁荣，等. 腹股沟薄层血管化淋巴结皮瓣移植术治疗乳腺癌术后Ⅲ期上肢淋巴水肿的护理[J]. 中国临床护理，2023, 15(8): 484-487.
[12]	田子睿，姚敏，王拥军，等. 中文版Constant-Murley肩关节评分量表的研制与应用[J]. 中医正骨，2019，31(5)：20-21.
[13]	方积乾，万崇华，史明丽，等. 生存质量研究概况与测定量表[J]. 现代康复，2000, 4(8): 1123-1126，1133.
[14]	Shen A, Qiang W, Zhang L, et al. Risk factors for breast cancer-related lymphedema: an umbrella review[J]. Ann Surg Oncol, 2024, 31(1): 284-302.
[15]	Braude L, Kirsten L, Gilchrist J, et al. A systematic review of women′s satisfaction and regret following risk-reducing mastectomy[J]. Patient Educ Couns, 2017, 100(12): 2182-2189.
[16]	Mcduff S, Mina A, Brunelle C, et al. Timing of lymphedema after treatment for breast cancer: when are patients most at risk？[J]. Int J Radiat Oncol Biol Phys, 2019, 103(1): 62-70.
[17]	郝元涛，方积乾，李彩霞，等. 世界卫生组织生命质量量表及其中文版 [J]. 国外医学(社会医学分册), 1999(3): 118-122.
[18]	刘英，李群，吕大鹏，等．有氧运动联合康复护理干预在乳腺癌术后淋巴水肿的应用效果[J].中华损伤与修复杂志(电子版)，2021，16(2)：170-174.

Please choose a citation manager

Content to export