Short-term Follow-up Study Of Breast Cancer Related Lymphedema (grade2)treated By Microsurgical Lymphaticovenous Implantation (MLVI) Combined With Compression Therapy

Objective:The purpose of this study is to evaluate preoperative enlargement and postoperative improvement of upper limb lymphedema patients who have undergone the MLVI surgery followed by compression therapy.Methods:From January 2013 to January 2015, patients with upper limb lymphedema treated with the MLVI procedure combined with compression therapy(observation group,n=23)and conservative therapy( control group,n=23) in our department were chosen. The circumferences of the affected and normal upper limbs were measured at two levels: distal(5 cm above the wrist) and proximal(5 cm below the cubital crease). Different sites’ circumference were evaluated and life quality after operation was observed to evaluate the effects. The circumferences of the affected and normal upper limbs were measured at two levels: distal(5cm above the wrist) and proximal(5cm below the cubital crease) were recorded, percent reduction of edema circumference(%REC) was calculated, and subjective assessment was taken to evaluate the effects.Results:In the observation group,operations were successfully performed.There was no problem with wound healing, including local infection,lymphorrhea or hematoma, compression therapy was performed after surgery.In the control group,conservative therapy was performed as planed successfully. In the observation group,the %REC of the proximal site was 0.55±0.11,and 0.63±0.15 of the distal site;which were 0.48±0.15 at the proximal site and 0.40±0.10 at the distal site in the control group. Wilcoxon test showed that treatment effect in the observation group is better than than that in the control group.Statistical comparisons between observation group and control group were made by t test, %REC of the proximal site and distal site between the observation group and control group was compared, and p-value < 0.05, which showed significant difference between observation group and control group.Conclusion:The MLVI surgery combined with compression therapy have shown better percent reduction of edema circumference than conservative therapy for the treatment of BCRL(grade 2)for the short-term. But long-term follow-up of this combined therapy is needed.