Bone and soft tissue sarcomas, tumors of the skinBone and soft tissue sarcomas, tumors of the skinСаркомы костей, мягких тканей и опухоли кожи2219-46142782-3687Publishing House ABV Press389RECONSTRUCTION SURGERYРЕКОНСТРУКТИВНАЯ ХИРУРГИЯModern aspects of surgical treatment of upper limb lymphedema in patients after combined treatment of breast cancerСовременные аспекты оперативного лечения лимфатических отеков верхних конечностей у пациентов после комплексного лечения рака молочной железыIvashkovV. Ju.ИвашковВ. Ю.
Russian Federation

Moscow

г. Москва

SobolevskyV. A.СоболевскийВ. А.
Russian Federation

Moscow

г. Москва

EgorovJu. S.ЕгоровЮ. С.
Russian Federation

Moscow

г. Москва

N.N. Blokhin Russian Cancer Research Center Ministry of Health of the Russian FederationФГБУ «РОНЦ им. Н.Н. Блохина» Минздрава России220120168170752201202222012022Copyright ©; 2016, Ivashkov V.J., Sobolevsky V.A., Egorov J.S.Copyright ©; 2016, Ивашков В.Ю., Соболевский В.А., Егоров Ю.С.2016Ivashkov V.J., Sobolevsky V.A., Egorov J.S.Ивашков В.Ю., Соболевский В.А., Егоров Ю.С.https://creativecommons.org/licenses/by/4.0https://sarbon.abvpress.ru/jour/article/view/389

Lymphedema – the consequence of surgical damage to the lymphatic vessels. This pathology is associated with lymph node and/or radiotherapy. selecting treatment methods lymphedema varies depending on the severity of edema and fibrosis of the affected limb. lymphovenous anastomosis is the most effective and long term solution for the treatment of lymphostasis limbs. The technique of vascularized transplantation of lymph nodes is to move the tissue containing the lymph nodes in the supply vessels, followed by the imposition of microsurgical anastomosis in the recipient area. This paper describes a clinical case of delayed reconstruction of the left breast TRAM-flap with simultaneous transfer of the inguinal lymph nodes in the axilla. The first evaluation of the effectiveness of the operation carried out 3 months after surgery, regression of lymphedema is about 29%. The use of modern methods of reconstructive surgery and high-tech equipment allows you to achieve both a good aesthetic results after surgical treatment of breast cancer, and significantly reduce lymphedema of the upper limbs.

Лимфатический отек – последствие хирургического повреждения лимфатических сосудов. Данная патология связана с лимфодиссекцией и/или лучевой терапией. Выбор методики лечения лимфатического отека варьирует в зависимости от тяжести отека и степени фиброза пораженной конечности. лимфовенозный анастомоз является наиболее эффективным и долгосрочным решением для лечения лимфостаза конечностей. Суть методики пересадки васкуляризированных лимфатических узлов состоит в перемещении клетчатки, содержащей лимфатические узлы на питающих сосудах, с последующим наложением микрохирургического анастомоза в реципиентной области. В данной работе описан клинический пример отсроченной реконструкции левой молочной железы тRам-лоскутом с одномоментной пересадкой паховых лимфатических узлов в аксиллярную область. первая оценка эффективности операции произведена спустя 3 мес после операции, регресс лимфатического отека составляет около 29%. использование современных методов реконструктивной хирургии и высокотехнологичного оборудования позволяет достичь как хорошего эстетического результата после хирургического лечения рака молочной железы, так и значительно уменьшить лимфатический отек верхних конечностей.

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