Background and Objectives:Breast cancer-related lymphedema (BCRL) is a complication of axillary lymph node dissection (ALND). Immediate lymphatic reconstruction (ILR) may help to decrease lymphedema after ALND by creating lymphatic bypasses. This retrospective single-institution study aimed to compare lymphedema in patients undergoing ALND with and without ILR.Materials and Methods:Bioimpedance and limb measurements determined the presence of BCRL. The categorical data that were collected and analyzed included BMI, comorbidities, BCRL onset, and number of lymphatic bypasses. Pearson’s chi-square test and multivariable logistic regression were performed to identify factors associated with the onset of lymphedema. An odds ratio compared the incidence of BCRL with and without ILR.Results:In total, 186 patients underwent ALND, 44 (24%) with ILR and 142 (76%) without. The mean number of bypasses during ILRs created was 3.54. The odds of developing lymphedema with ILR were 64% lower than for ALND alone. ILR patients who developed BCRL had a mean onset of 543 days post-operatively versus 389 days in the control group. Age, ethnicity, BMI, and bypass amount had no significant influence on lymphedema development.Conclusions:ILR was associated with lower rates of BCRL after ALND. Patients who developed lymphedema despite undergoing ILR did so 8 months later than the controls.
背景与目的：乳腺癌相关淋巴水肿是腋窝淋巴结清扫术后常见并发症。即时淋巴重建技术通过建立淋巴旁路分流，可能有助于降低腋窝淋巴结清扫术后淋巴水肿发生率。本研究为单中心回顾性分析，旨在比较接受腋窝淋巴结清扫术患者中，联合与未联合即时淋巴重建技术对淋巴水肿发生的影响。 材料与方法：通过生物阻抗与肢体周径测量判定乳腺癌相关淋巴水肿。收集并分析分类数据包括体重指数、合并症、淋巴水肿发生时间及淋巴旁路数量。采用皮尔逊卡方检验与多因素逻辑回归分析淋巴水肿相关因素，并通过比值比比较联合与未联合即时淋巴重建技术患者的淋巴水肿发生率。 结果：共纳入186例接受腋窝淋巴结清扫术患者，其中44例（24%）联合即时淋巴重建技术，142例（76%）未联合。即时淋巴重建术中平均建立3.54条淋巴旁路。联合即时淋巴重建技术患者发生淋巴水肿的风险较单纯腋窝淋巴结清扫术患者降低64%。即时淋巴重建组发生淋巴水肿患者的平均术后发生时间为543天，对照组为389天。年龄、种族、体重指数及旁路数量对淋巴水肿发生无显著影响。 结论：即时淋巴重建技术与降低腋窝淋巴结清扫术后淋巴水肿发生率相关。即使发生淋巴水肿，联合该技术患者的发病时间较对照组延迟约8个月。
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