Archives of Plastic Surgery

  • 제33권3호
  • /
  • Pages.294-297
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  • 2006
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
권호 표지

광배근근피판을 이용한 유방재건술이 림프부종에 미치는 영향

The Effects of Breast Reconstruction Using Latissimus Dorsi Myocutaneous Pedicled Flap for Lymphedema

  • 박정민 (동아대학교 의과대학 성형외과학교실(유방센터)) ;
  • 허정 (동아대학교 의과대학 성형외과학교실(유방센터)) ;
  • 하재성 (동아대학교 의과대학 성형외과학교실(유방센터)) ;
  • 이근철 (동아대학교 의과대학 성형외과학교실(유방센터)) ;
  • 김석권 (동아대학교 의과대학 성형외과학교실(유방센터)) ;
  • 조세헌 (동아대학교 의과대학 외과학교실(유방센터)) ;
  • 이경우 (동아대학교 의과대학 재활의학과학교실(유방센터))
  • Park, Jung Min (Department of Plastic and Reconstructive Surgery, College of Medicine, Dong-A University) ;
  • Heo, Jung (Department of Plastic and Reconstructive Surgery, College of Medicine, Dong-A University) ;
  • Ha, Jae Sung (Department of Plastic and Reconstructive Surgery, College of Medicine, Dong-A University) ;
  • Lee, Keun Cheol (Department of Plastic and Reconstructive Surgery, College of Medicine, Dong-A University) ;
  • Kim, Seok Kwun (Department of Plastic and Reconstructive Surgery, College of Medicine, Dong-A University) ;
  • Jo, Se Heon (Department of Surgery, College of Medicine, Dong-A University) ;
  • Lee, Kyung Woo (Department of Rehabilitative Medicine Breast Center, College of Medicine, Dong-A University)
  • 투고 : 2005.10.17
  • 발행 : 2006.05.10
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초록

Lymphedema is one of the most common complications of mastectomy. It decreases quality of life and causes functional or aesthetical problems in post-mastectomy patients. Axillary lymph needs dissection (ALND), and radiation therapy(RTx) is known as the representative factor of lymphedema. Authors discovered that breast reconstructions using latissimus dorsi(LD) myocutaneous flap decrease the incidence of lymphedema in spite of these risk factors. Therefore we compared the incidence of lymphedema between the patients who underwent breast reconstructoins by LD pedicled flap, and the patients who did not undergo breast reconstructions from January 2002 to December 2004. Lymphedema was diagnosed when difference of arm circumference was over 2cm or limitation of joint movement was greater than 20 degrees. Overall incidence of lymphedema was 14.0%, and it was 18.9% in case of ALND, and 21.1% in case of RTx, respectively. But the incidence of breast-reconstructed patients using LD pedicled flap was 3.3%. This result reveals that LD pedicled flap decreases incidence of lymphedema significantly. In the future, it is recommended to identify the causes of decrease in the incidence of lymphedema in case of breast reconstructed by LD myocutaneous pedicled flap, for example lymphoscintigraphy and so on.

키워드

참고문헌

  1. Althuis MD, Dozier JM, Anderson WF, Devesa SS, Brinton LA: Global trends in breast incidence and mortality 1973-1997. Int J Epidemiol 34: 405, 2005 https://doi.org/10.1093/ije/dyh414
  2. Anderson PR, Hanlon AL, Fowble BL, McNeeley SW, Freedman GM: Low complication rates are achievable after postmastectomy breast reconstruction and radiation therapy. Int J Radiat Oncol Biol Phys 59: 1080, 2004 https://doi.org/10.1016/j.ijrobp.2003.12.036
  3. Voogd AC, Ververs JM, Vingerhoets AJ, Roumen RM, Coebergh JW, Crommelin MA: Lymphoedema and reduced shoulder function as indicators of quality of life after axillary lymph node dissection for invasive breast cancer. Br J Surg 90: 76, 2003 https://doi.org/10.1002/bjs.4010
  4. Ivens D, Hoe AL, Podd TJ, Hamilton CR, Tayler I, Royle GT: Assessment of morbidity from complete axillary dissection. Br J Cancer 66: 136, 1992 https://doi.org/10.1038/bjc.1992.230
  5. Larson D, Weinstein M, Goldberg I, Silver B, Recht A, Cady B, Silen W, Harris JR: Edema of the arm as a function of the extent of axillary surgery in patients with stage I-II carcinoma of the breast treated with primary radiotherapy. Int J Radiat Oncol Biol Phys 12: 1575, 1986 https://doi.org/10.1016/0360-3016(86)90280-4
  6. Foldi M, Foldi E, Kubik S: Textbook of lymphology for physicians and lymphedema therapists. 1st ed, San Francisco, Urban & Fisher, Verlag 2003
  7. Kissin MW, Querci della Rovere G, Easton D, Westbury G: Risk of lymphoedema following the treatment of breast cancer. Br J Surg 73: 580, 1986 https://doi.org/10.1002/bjs.1800730723
  8. Delouche G, Bachelot F, Premont M, Kurtz JM: Conservation treatment of early breast cancer: long-term results and complications. Int J Radiat Oncol Biol Phys 13: 29, 1987 https://doi.org/10.1016/0360-3016(87)90256-2
  9. Rampaul RS, Mullinger K, Macmillan RD, Cid J, Holmes S, Morgan DA, Blamey RW: Incidence of clinically significant lymphoedema as a complication following surgery for primary operable breast cancer. Eur J Cancer 39: 2165, 2003 https://doi.org/10.1016/S0959-8049(03)00539-2
  10. Herd-Smith A, Russo A, Muraca MG, Del Turco MR, Cardona G: Prognostic factors for lymphedema after primary treatment of breast carcinoma. Cancer 92: 1783, 2001 https://doi.org/10.1002/1097-0142(20011001)92:7<1783::AID-CNCR1694>3.0.CO;2-G
  11. Johansen J, Overgaard J, Blichert-Toft M, Overgaard M: Treatment morbidity associated with the management of the axilla in breast-conserving therapy. Acta Oncol 39: 349, 2000 https://doi.org/10.1080/028418600750013122
  12. Kiel KD, Rademacker AW: Early stage breast cancer: arm edema after wide excision and breast irradiation. Radiology 198: 279, 1996 https://doi.org/10.1148/radiology.198.1.8539394
  13. Pierquin B, Mazeron JJ, Glaubiger D: Conservative treatment of breast cancer in Europe: report of the groupe europeen de curietherapie. Radiother Oncol 6: 187, 1986 https://doi.org/10.1016/S0167-8140(86)80153-0
  14. Danoff BF, Goodman RL, Glick JH, Haller DG, Pajak TF: The effect of adjuvant chemotherapy on cosmesis and complications in patients with breast cancer treated by definitive irradiation. Int J Radiat Oncol Biol Phys 9: 1625, 1983 https://doi.org/10.1016/0360-3016(83)90414-5