Objective:To evaluate the effectiveness of bloodletting puncture and cupping in relieving breast cancer-related lymphedema.Methods:We conducted a non-randomized controlled study at the Galactophore Department of the 3...Objective:To evaluate the effectiveness of bloodletting puncture and cupping in relieving breast cancer-related lymphedema.Methods:We conducted a non-randomized controlled study at the Galactophore Department of the 3rd Affiliated Hospital of Beijing University of Chinese Medicine from March 2013 to December 2014.Seventy-five patients undergoing treatment for breast cancer-related lymphedema were divided into two groups in accordance with the patients' treatment choices:the treatment group (n =50) underwent bloodletting puncture and cupping every 5 days for 15 min/session (one session per day) combined with exercise training once a day for 30 minutes;the control group (n =25) underwent the same exercise training alone.Evaluation indexes were measured before and after treatment;these included arm circumference (at the wrist crease,10 cm distal to the wrist crease,the elbow crease,and 10 cm distal to the elbow crease)and visual analogue scale (VAS) score for pain.The safety of the treatment was also evaluated.Results:The treatment period was 50 days for all 75 patients.At the end of the treatment period,the mean reduction in arm circumference was 1.21 (0.65) cm the treatment group,and 0.58 (0.78) cm in the control group.Compared with the control group,the treatment group had a significantly greater reduction in arm circumference (P =.03) and a significantly lower VAS score for pain (P =.01).No patient in either group experienced any adverse events.Conclusion:Bloodletting puncture and cupping effectively reduces arm circumference and relieves upper limb pain in patients with breast cancer-related lymphedema.Our results provide sufficient basis for exploring cupping as long-term therapy for managing breast cancer-related lymphedema.展开更多
With the remarkable advancement of microsurgery,surgical treatment for lymphedema has been increasing,and its good results are well established.However,surgical treatment for advanced-stage lymphedema is still a chall...With the remarkable advancement of microsurgery,surgical treatment for lymphedema has been increasing,and its good results are well established.However,surgical treatment for advanced-stage lymphedema is still a challenging task.We reviewed several methods of combining lymphovenous anastomosis(LVA)and vascularized lymph node transfer(VLNT)in breast cancer-related lymphedema(BCRL)patients.Representative VLNT flap options for BCRL patients include the omental flap,superficial circumflex iliac perforator(SCIP)flap,and deep inferior epigastric artery(DIEA)flap combined with inguinal lymph nodes performed simultaneously with breast reconstruction.The surgical outcome,technical details,and donor site morbidities of each surgical option were reviewed.While all three options show significant surgical benefits,each has its clear advantages and disadvantages.The decision on the surgical method may vary according to the needs of each patient and the clinical situation.展开更多
Aim:Lymphaticovenous anastomosis(LVA)is the mainstay for treating breast cancer-related lymphedema(BCRL).Preoperative ultrasonography is useful to assess the locations and characteristics of lymphatics and veins to im...Aim:Lymphaticovenous anastomosis(LVA)is the mainstay for treating breast cancer-related lymphedema(BCRL).Preoperative ultrasonography is useful to assess the locations and characteristics of lymphatics and veins to improve LVA success remarkably even in cases of advanced BCRL.Aim:The aim of the study was to describe the use of ultrasonography to reliably map suitable lymphatics and veins and successfully perform LVA surgery in cases of advanced BCRL.Method:This retrospective cohort study included 41 cases of BCRL who underwent LVA surgery using preoperative ultrasound to map and characterize lymphatics and veins.Cases were analyzed for the following:(1)whether preoperative ultrasonographic detection of both lymphatics and veins correlate to actual intraoperative findings and(2)improvement in mean limb circumference measurements at 1 and 3 months of follow-up in this patient cohort.Results:For 155 LVA incisions,212 LVA procedures were performed.Among them,133(62.7%)lymphatics and 196(92.4%)anti-reflux veins were successfully detected and characterized on preoperative sonography.Mean preoperative circumference at the wrist,10cm below elbow,elbow,and 10cm above elbow were 18.86 cm,27.79 cm,29.75 cm,and 33.77 cm,respectively.The mean measurements improved at 1 month correspondingly to 17.14 cm,24.86 cm,26.91 cm,and 30.50 cm(9.12%,10.54%,9.54%,9.70%improvement,respectively),and at 3 months to 16.59 cm,24.28 cm,26.55 cm,and 30.05 cm(12.02%,12.63%,10.73%,11.02%improvement,respectively).For each individual patient,their four measured circumferences were also added to obtain the Total Circumference(TC).The TC ranged from 89-135 cm(mean 109.46 cm)preoperatively,83.5-129.5 cm(mean 98.74 cm)1-month post-op,and 80.5-128 cm(mean 96.55 cm)3 months post-op.Compared to the preoperative value,each patient had a TC decrease of 2.79%-20.35%(mean 9.80%)at 1-month post-op and 4.39-28.30%(mean 11.80%)at 3 months post-op.These differences were all statistically significant(P<0.0001).Conclusion:Preoperative ultrasonography is a useful adjunct to detect lymphatic vessels and anti-reflux veins,thereby increasing the chances of successfully performing LVA surgery even in cases of advanced upper limb lymphedema.It can contribute to long-lasting outcomes.展开更多
文摘Objective:To evaluate the effectiveness of bloodletting puncture and cupping in relieving breast cancer-related lymphedema.Methods:We conducted a non-randomized controlled study at the Galactophore Department of the 3rd Affiliated Hospital of Beijing University of Chinese Medicine from March 2013 to December 2014.Seventy-five patients undergoing treatment for breast cancer-related lymphedema were divided into two groups in accordance with the patients' treatment choices:the treatment group (n =50) underwent bloodletting puncture and cupping every 5 days for 15 min/session (one session per day) combined with exercise training once a day for 30 minutes;the control group (n =25) underwent the same exercise training alone.Evaluation indexes were measured before and after treatment;these included arm circumference (at the wrist crease,10 cm distal to the wrist crease,the elbow crease,and 10 cm distal to the elbow crease)and visual analogue scale (VAS) score for pain.The safety of the treatment was also evaluated.Results:The treatment period was 50 days for all 75 patients.At the end of the treatment period,the mean reduction in arm circumference was 1.21 (0.65) cm the treatment group,and 0.58 (0.78) cm in the control group.Compared with the control group,the treatment group had a significantly greater reduction in arm circumference (P =.03) and a significantly lower VAS score for pain (P =.01).No patient in either group experienced any adverse events.Conclusion:Bloodletting puncture and cupping effectively reduces arm circumference and relieves upper limb pain in patients with breast cancer-related lymphedema.Our results provide sufficient basis for exploring cupping as long-term therapy for managing breast cancer-related lymphedema.
文摘With the remarkable advancement of microsurgery,surgical treatment for lymphedema has been increasing,and its good results are well established.However,surgical treatment for advanced-stage lymphedema is still a challenging task.We reviewed several methods of combining lymphovenous anastomosis(LVA)and vascularized lymph node transfer(VLNT)in breast cancer-related lymphedema(BCRL)patients.Representative VLNT flap options for BCRL patients include the omental flap,superficial circumflex iliac perforator(SCIP)flap,and deep inferior epigastric artery(DIEA)flap combined with inguinal lymph nodes performed simultaneously with breast reconstruction.The surgical outcome,technical details,and donor site morbidities of each surgical option were reviewed.While all three options show significant surgical benefits,each has its clear advantages and disadvantages.The decision on the surgical method may vary according to the needs of each patient and the clinical situation.
文摘Aim:Lymphaticovenous anastomosis(LVA)is the mainstay for treating breast cancer-related lymphedema(BCRL).Preoperative ultrasonography is useful to assess the locations and characteristics of lymphatics and veins to improve LVA success remarkably even in cases of advanced BCRL.Aim:The aim of the study was to describe the use of ultrasonography to reliably map suitable lymphatics and veins and successfully perform LVA surgery in cases of advanced BCRL.Method:This retrospective cohort study included 41 cases of BCRL who underwent LVA surgery using preoperative ultrasound to map and characterize lymphatics and veins.Cases were analyzed for the following:(1)whether preoperative ultrasonographic detection of both lymphatics and veins correlate to actual intraoperative findings and(2)improvement in mean limb circumference measurements at 1 and 3 months of follow-up in this patient cohort.Results:For 155 LVA incisions,212 LVA procedures were performed.Among them,133(62.7%)lymphatics and 196(92.4%)anti-reflux veins were successfully detected and characterized on preoperative sonography.Mean preoperative circumference at the wrist,10cm below elbow,elbow,and 10cm above elbow were 18.86 cm,27.79 cm,29.75 cm,and 33.77 cm,respectively.The mean measurements improved at 1 month correspondingly to 17.14 cm,24.86 cm,26.91 cm,and 30.50 cm(9.12%,10.54%,9.54%,9.70%improvement,respectively),and at 3 months to 16.59 cm,24.28 cm,26.55 cm,and 30.05 cm(12.02%,12.63%,10.73%,11.02%improvement,respectively).For each individual patient,their four measured circumferences were also added to obtain the Total Circumference(TC).The TC ranged from 89-135 cm(mean 109.46 cm)preoperatively,83.5-129.5 cm(mean 98.74 cm)1-month post-op,and 80.5-128 cm(mean 96.55 cm)3 months post-op.Compared to the preoperative value,each patient had a TC decrease of 2.79%-20.35%(mean 9.80%)at 1-month post-op and 4.39-28.30%(mean 11.80%)at 3 months post-op.These differences were all statistically significant(P<0.0001).Conclusion:Preoperative ultrasonography is a useful adjunct to detect lymphatic vessels and anti-reflux veins,thereby increasing the chances of successfully performing LVA surgery even in cases of advanced upper limb lymphedema.It can contribute to long-lasting outcomes.
