A Follow-up Study Of Endometrial Cancer Related Lymphedema(grade 2)Treated By Lymphaticovenous Implantation Combined With Complete Decongestive Therapy(CDT)

Objective:To verify and explore the effect of combined lymphadenopathy and complete decongestive therapy(CDT)on stage 2 stage lymphedema of lower extremity after endometrial cancer surgery.Methods:From January 2016 to January 2018,34 patients(50 limbs)who received surgery for endometrial cancer,were diagnosed with lower extremity lymphedema at China-Japan union hospital of Jilin University in department of Vascular Surgery,and their clinical data were analyzed retrospectively.According to the clinical treatment,the patients were divided into two groups:17 patients(25 limbs)in the observation group treated by lymphaticovenous implantation combined with CDT;and 17 patients(25 limbs)in the control group only treated by CDT.Before treatment,the following data of the patients were measured:the circumference of 10cm above the superior border of patella,the superior border of patella,10cm below the inferior border of patella,and the ankle joint.The patients were discharged after 2 weeks of adjuvant treatment and followed up for 6 months after discharge.According to the lower extremity lymphedema index(LELI),the edema circumference reduction rate(ECRR)and the ubjective treatment effect,analyze and compare the clinical efficacy difference between the two groups by using Mann-Whitney U test.Results:In 17 patients,the operation success rate was 100%,the operation time was 120-150min without any complications occurred during or after surgery(eg,wound infection,lymphatic fistula,incision non-healing,etc.).Postoperative recovery was great.Both groups were given routine medication and CDT treatment.The treatment process was smooth.All 34 patients were followed up regularly for 6 months.The follow-up content was the subjective judgment of the patient’s recovery status and the measurement of the circumference of each part of the limb.Use Mann-Whitney U test to compare the differences between groups.The results showed that the changes of total LELI,proximal and distal limb LELI in the observation group were significantly higher than those in the control group(P<0.01),and the changes of total ECRR,proximal and distal limb ECRR in the observation group were significantly higher than those in the control group(p=0.001,<0.001 and 0.032).The curative effect of observation was better than that of control group,and the difference was statistically significant(P=0.002).No serious cases such as death of the patient occurred during the follow-up period.Conclusion:The lymphaticovenous implantation combined with complete decongestive therapy(CDT)has an obvious advantage in the treatment of endometrial cancer related lymphedema(grade 2)compared with conservative theraphy.However,long-term follow-up is still needed.