Analysis Of The Efficacy Of Lymphangiovenous Anastomosis Combined With Detumescence Therapy For Upper Extremity Moderate Lymphedema After Breast Cancer Surgery

Objective:To analyze the efficacy of MLVA combined with CDT for upper extremity moderate lymphedema(BCRL)after radical mastectomy for breast cancer.Methods:40 patients with moderate upper limb lymphedema after breast cancer surgery admitted to our hospital from August 2017 to August 2018 were randomly divided into two groups.Observation group(surgery group)(n=20)received lymphangiovenous anastomosis combined with compound detumescence therapy;The control group(n=20)received compound detumescence therapy.Lymphangiography of the upper limbs was performed before and after treatment in both groups,and the circumference of the upper arm 5cm above the transverse cubital striae and the forearm 5cm below the transverse cubital striae before and after treatment in both groups were measured.In addition,patients in the observation group received a return visit at 3 months and 6 months after discharge,and each patient received a total of 2 times of return visits,the limb circumference of the patients was recorded,the limb detumescence rate%REC was analyzed,and subjective feelings and symptoms of the patients were questioned.Combined with clinical data,objective examination,patients' subjective feelings and symptoms,the efficacy difference between the two groups was compared and the efficacy within the observation group was emphatically analyzed for in-depth analysis.Results:The surgery of all patients in the observation group was successfully completed.Postoperative combined with compound detumescence therapy,the follow-up limb recovery was good,the incision healing was good,no lymphatic fistula appeared without doubt similar inflammatory reaction.The control group was treated with compound detumescence therapy.Data of the two groups were obtained accordingly.The proximal%REC value(0.56±0.11)and distal%REC value(0.52±0.10)of the observation group,and the proximal%REC value and distal%REC value of the control group were(0.46±0.11)and(0.41±0.08),respectively.The results of lymphangiography of the two groups before and after treatment were analyzed and compared.The lymphatic aggregation area of the observation group was significantly decreased,and the degree of decrease was significantly higher than that of the control group.The rank sum test and t test were used to analyze the%REC data of upper arm circumference limb and forearm circumference limb of 40 patients,and P value was less than 0.05,which was statistically significant.In the observation group,the circumference of the upper arm was(33.8±2.9),(31.1±2.7),(30.±0 2.8)cm,and(30.2±2.9),(27.9±2.5),and(26.4±2.6)cm,respectively,before and 3 and 6 months after surgery.Patients' upper arm and forearm circumference decreased significantly 3 and 6 months after surgery,and the difference was statistically significant(P<0.05).All the patients felt edema relieved after discharge,the patients in the observation group felt edema reduced more significantly,while the patients in the control group felt edema slightly reduced,with occasional recurrence.Conclusion:Lymphangiovenous anastomosis combined with compound detume-scence therapy has a relatively good effect on the moderate postoperative lymphedema of breast cancer,and the limb detumescence rate is better than the simple compound detumescence therapy,and the long-term efficacy needs further observation.