淋巴系统转移（LYST）在淋巴水肿治疗中的作用：一项结合淋巴结和传入淋巴管的SCIP皮瓣的长期疗效研究。

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery Pub Date : 2025-02-01 DOI:10.1016/j.bjps.2024.11.052

Hidehiko Yoshimatsu , Min-Jeong Cho , Ryo Karakawa , Akira Okada , Akitatsu Hayashi , Yuma Fuse , Tomoyuki Yano

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引用次数: 0

摘要

背景：血管化淋巴结转移（VLNT）传统上用于晚期淋巴水肿患者。为了增强和促进VLNT的生理作用，淋巴系统转移（LYST）被开发出来。在这种技术中，淋巴结及其相应的一部分传入淋巴管被转移以刺激淋巴管生成。本研究介绍了我们使用旋髂浅动脉穿支LYST的经验、要点和缺陷。方法：回顾性分析2018年7月至2022年3月接受LYST治疗淋巴水肿的患者。分析患者特征、围手术期资料和长期结果。结果：8例单侧下肢淋巴水肿患者行LYST治疗。平均随访时间为39.0（24.0 ~ 60.0）个月。最后一次随访时，与未受影响肢体相比，多余体积百分比的平均改善为11.2%（100%改善，0%恶化），差异有统计学意义（p < 0.001）。蜂窝织炎发生率降低，差异有统计学意义（p = 0.025）。结论：LYST皮瓣用于淋巴水肿治疗的长期研究尚未完成。这项研究表明，LYST手术在治疗晚期淋巴水肿患者方面提供了可靠和有效的长期结果。

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The role of lymphatic system transfer (LYST) for treatment of lymphedema: A long-term outcome study of SCIP flap incorporating the lymph nodes and the afferent lymphatic vessels

Background

Vascularized lymph node transfer (VLNT) is traditionally performed in patients with advanced-stage lymphedema. To enhance and promote the physiological effects of VLNT, lymphatic system transfer (LYST) was developed. In this technique, lymph nodes and a portion of their corresponding afferent lymphatic vessels are transferred to stimulate lymphangiogenesis. This study presented our experience, pearls, and pitfalls of using superficial circumflex iliac artery perforator LYST.

Methods

A retrospective review of patients treated with LYST for lymphedema treatment from July 2018 to March 2022 was included. Patient characteristics, perioperative data, and long-term outcomes were analyzed.

Results

Eight patients with unilateral lower-extremity lymphedema underwent LYST. The mean follow-up duration was 39.0 (24.0–60.0) months. The mean improvement in the excess volume percentage compared to the unaffected limb was 11.2% (100% improvement to 0% worsening) at the last follow-up, with statistical significance (p < 0.001). The incidence of cellulitis decreased with statistical significance (p = 0.025).

Conclusion

A long-term study on using LYST flaps in lymphedema treatment has not been previously performed. This study showed that the LYST procedure provides reliable and effective long-term outcomes in treating patients with advanced-stage lymphedema.

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来源期刊

Journal of Plastic Reconstructive and Aesthetic Surgery 医学-外科

CiteScore

3.10

自引率

11.10%

发文量

578

审稿时长

3.5 months

期刊介绍： JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.