20 cases of chronic lymphedema of theleg were examined by lymphoscintigraphybefore and after Heating and Bandage Treat-ment. The result showed that lymph flowwere improved in 17 cases, edematous legsafter the treatment, among these, lymphflow were much improved in 4 patients, al-most reaching a normal state. The compari-son of clarity and appearing time of imagesand the comparison of lymph flow rate be-fore and after the treatment also showed sta-tistical significance. It is further proved from this study that Heating and Bandage Treatment can improve lymphatic circulation in lymphedematous limbs.
Thirteen cases of unilateral lymphedema of lower extremity were treated by the anastomosis between the suporficial and deep lymphaties. The rate of subeidence of edema at 2 weeks and 6 months after operation were 57.1±18.5%and 47.3± 22.9%, respectively, It was believed that this type of oporation had the advantageS of anastomosis on the tissues of same origin, unlikely occurrence of thrombosis at the anastomotic stoma, small incision, less surgical trauma and acceptable by patients.
By using biochemical assessment technique and histological examination,a comparative study of the cutaneous tissues in 16 patients with lymphedema of the lower extremity before and after the heating and bandage therapy, and it was noted thatthe heating and bandage therapy might:(1) the content of hydroxyproline in the affected skin would be decreased; (2) the thickness of skin was decreased and the water content was reduced; (3) the microcirculation of local tissues was enhanced, and (4) the activity of the macrophages was increased. In conjunction with the criteria of clinical observation, the action mechanism of heating and bandage therapy might be as follows: (1) improve the local microcirculation and enhance the resorption of tissue fluid and the protein, and (2) increase the activity of the macrophages, and minimize the extent of fibrosis of the affected tissues.
OBJECTIVE To observe the character of local and systemic immune responses in chronic limb lymphedema, and to investigate the effect of microwave on immunological response. METHODS From November 1996 to February 1998, 27 patients with chronic limb lymphedema were adopted in this study. Among them, there were 11 males and 16 females, the average age was 36.6 years. These patients were classified as the experimental group and 10 healthy volunteers as the control group. Before and after microwave heating and bandaging treatment, T and B lymphocyte in peripheral blood and skin infiltrating cells in the patients and volunteers were detected and phenotyped with alkaline phosphatase-anti-alkaline phosphatase(APAAP) and avidin biotin peroxidase complex (ABC) immunohistochemical methods respectively. RESULTS There were decreases of CD4+ T lymphocyte and the ratio of CD4+/CD8+ in peripheral blood and predominant dermal perivascular T lymphocyte infiltration in chronic limb lymphedema patients. After two courses of microwave heating and bandaging treatment, it was found that the number of CD4+ T lymphocytes increased and the ratio of CD4+/CD8+ was restored to normal levels, and dermal perivascular T lymphocyte infiltration decreased greatly. CONCLUSION Microwave heating and bandaging treatment can modulate the systemic and local immunological imbalance of chronic limb lymphedema.
Objective To study a new method of treatment for upper limb lymphedema after radical mastectomy. Methods From Jun. 2001 to Sep. 2003, 11 cases(2with complication of erysipelas ) of upper limb lymphedema being treated with radical mastectomy for more than 2 years were used as model. All the edema of limbs was sucked from hypodermis with liposuction technique and compressed with compression garment. Three months after operation, elasticity stress was conducted every night. Results The reduction of the edema of upper limbswas remarkable. The average decrease of circumference was 4 cm. No erysipelas was observed. Conclusion The liposuction technique and elasticity stress is a new and effective approach to the treatment of upper limb lymphedema.
目的探讨肢体淋巴水肿疾病中相关恶性肿瘤的诊断与治疗。方法对我院 1988年10月至2000年12月收治的332例肢体淋巴水肿患者，根据临床表现，用B超、淋巴管造影、静脉造影或CT等手段作为病因诊断检查，对可疑恶性肿瘤病例用穿刺、局部切除或局部探查的方法共活检20例。结果检出由恶性肿瘤引发的淋巴水肿18例,其中原发淋巴系统恶性肿瘤4例，均为下肢； 继发性淋巴结转移癌14例，上、下肢各7例，并予相应治疗。结论重视本病临床表现，可使患者获得及早诊断，及时治疗。
ObjectiveTo investigate the therapeutic effect of modified side-to-end lymphaticovenular anastomosis in the treatment of post-mastectomy upper limb lymphedema. MethodsBetween May 2010 and May 2011, 11 female patients with post-mastectomy upper limb lymphedema underwent a modified side-to-end lymphaticovenular anastomosis. The average age was 49.5 years (range, 38-55 years). Lymphedema occurred at 7-30 months (mean, 18.3 months) after resection of breast cancer, with an average disease duration of 25.5 months (range, 10-38 months). The left upper limb was involved in 5 cases and the right upper limb in 6 cases. In accordance with difference value between health and affected sides criteria, 5 cases were rated as moderate, and 6 cases as severe. ResultsModified side-to-end lymphaticovenular anastomosis was successfully completed in all patients. Primary healing of incision was obtained in the other patients except 1 case of delayed healing. All patients were followed up for an average of 38.4 months (range, 36-40 months). Limb pain and swelling were relieved; no episodic attack or recurrence was observed. The circumference of affected upper arm was significantly decreased from preoperative (33.9±3.7) cm to postoperative (31.0±3.5) cm at 6 months and (30.9±3.5) cm at 36 months (P<0.05), but no significant difference was found between at 3 and 6 months (P>0.05); the circumference of affected forearm was significantly decreased from preoperative (30.1±3.6) cm to postoperative (27.8±3.4) cm at 6 months and (27.7±3.3) cm at 36 months (P<0.05), but no significant difference was shown between at 6 and 36 months (P>0.05). According to Campisi evaluation standard to assess efficacy, the results were excellent in 3 cases, good in 6 cases, and improved in 2 cases. ConclusionUsing modified side-to-end lymphaticovenular anastomosis may be effective in the treatment of upper limb lymphedema after mastectomy.
Abstract Sixty-four cases of upper limb lymphedema following radical operation of carcinoma of breast were treated by microwave therapy. The course of treatment was divided into two stages. Each stage was one hour a day for 20 days. Elastic band was put on the limb betweenevery therapy except the time of sleeping at night. After 1 months to 2 years follow-up, the results showed: symptoms disappeared obviously; the edema had gone down (Plt;0.01). The relapse frequency of erysipelas-like syndrome decreased obviously (Plt;0.01). The skin elasticity restored, and no complication appeared. It was concluded that microwave therapy was an effective conservative treatment in treating upper limb lymphedema following radical operaion of carcinoma of breast.
Objective To review the current progress of clinical and experimental research of vascularized lymph node transfer for lymphedema. Methods The domestic and abroad literature about vascularized lymph node transfer in treatment of lymphedema was reviewed and analyzed. Results Experimental studies in animal model indicate that vascularized lymph node transfer can improve lymph node survival and show a promising effectiveness in reducing lymphedema. " Lymphatic wick” and " lymph pump” were the two main hypotheses proposed to explain the potential functional mechanism of vascularized lymph node transfer in treatment of lymphedema. Improvement in lymphedema symptoms are reported in most of the clinical trials, but the level of evidence to advocate this procedure in the treatment of lymphedema remains low because of the small number of the cases and problems in their methodologies. Conclusion Based on current evidence, vascularized lymph node transfer seems to be a promising treatment for lymphedema, but long-term well-designed studies are required to further explore the effectiveness of this procedure.
The Influence of microwave and hot water immersion hyperthermia on the lymphedematous skin of lower extremity on 12 patients was studied by using immunohistochemical and lymphoscintigraphic methods. We assumed that the subsidence of inflammatory changes in the lymphedematous limb and/or local absorption of tissue fluid protein following local microwave heating, but not the augmented lymph How seemed to be responsible for the reduction of edema.