Immediate lymphatic reconstruction with targeted lymphatic axillary repair
Current surgical treatment for established lymphedema can be challenging and not always successful. To reduce the incidence of post-operative lymphedema, we began trialing targeted lymphatic axillary repair (TLAR) as a technique for immediate lymphatic reconstruction with the aim of reducing post-op...
| Autores: | , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| Repositorio: | Recercat. Dipósit de la Recerca de Catalunya |
| OAI Identifier: | oai:recercat.cat:20.500.12328/4954 |
| Acceso en línea: | http://hdl.handle.net/20.500.12328/4954 https://dx.doi.org/10.1016/j.bjps.2024.09.088 |
| Access Level: | acceso abierto |
| Palabra clave: | Càncer de mama Limfedema Limfedema relacionat amb el càncer de mama Cirurgia limfàtica Reconstrucció limfàtica Reconstrucció limfàtica immediata Cáncer de mama Linfedema Linfedema relacionado con el cáncer de mama Cirugía linfática Reconstrucción linfática Reconstrucción linfática inmediata Breast cancer Lymphedema Breast cancer-related lymphedema Lymphatic surgery Lymphatic reconstruction Immediate lymphatic reconstruction 616 |
| Sumario: | Current surgical treatment for established lymphedema can be challenging and not always successful. To reduce the incidence of post-operative lymphedema, we began trialing targeted lymphatic axillary repair (TLAR) as a technique for immediate lymphatic reconstruction with the aim of reducing post-operative lymphedema incidence. In this observational prospective study, conducted between March 2017 and May 2022, we assessed the effectiveness of TLAR in reducing lymphedema occurrence in consecutive breast cancer patients who underwent surgery involving axillary lymph node dissection (ALND). Patients meeting the inclusion criteria were considered for simultaneous lymphedema risk-reducing surgery using TLAR. They were monitored for a minimum of 18 months by medical physiotherapists, and post-operative testing was conducted using indocyanine green lymphography. Among the 50 women who underwent TLAR, 34 (68%) received neoadjuvant chemotherapy. On an average, 2.18 lymphatics were identified per patient, with a mean of 1.84 lymphatico-venous anastomoses performed. Adjuvant axillary radiotherapy was administered to 41 patients (82%), with axillary levels I-II spared from direct radiotherapy in 24 patients (48%). Only 2 patients (4%) developed lymphedema during the minimum 18.2-month follow-up period. In conclusion, TLAR is shown to be a safe, effective, and physiologic technique for reducing lymphedema risk in patients with breast cancer. |
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