CLINICAL OBSERVATION OF THE EFFECTIVENESS OF SURGICAL CORRECTION SECONDARY LYMPHEDEMA IN PATIENTS AFTER COMBINED TREATMENT OF ONCOLOGICAL DISEASES OF THE PELVIC ORGANS IN ONCOGYNECOLOGY
DOI:
https://doi.org/10.11603/2414-4533.2024.1.14643Keywords:
lymphedema, lymphodynamics, lymphovenousanastamoses, lymphography, transfer of vascularized lymph nodesAbstract
The aim of the work: to investigate the effectiveness of the vascularized lymph nodes transfer (VLNT) in the treatment of secondary lymphedema in patients after combined treatment of oncological diseases in oncogynecology.
Materials and Methods. The observation group consisted of 5 patients who underwent assessment of functioning lymphatic ducts and visualization of the lymphatic system and the anatomy of the groin using computed tomography with intravenous enhancement, ultrasound Doppler, and lymphography using ICG (indocyanide green) contrast. In our work, we used the VLNT method, i.e. transfer of vascularized lymph nodes.
Results and Discussion. Clinical evidence of the effectiveness of the indicated method of treatment of lymphostasis is the result of the treatment of patient V., 63 years old, who was treated at the Bukovynian Clinical Oncology Center in Chernivtsi since June 13, 2023. to 21.06.2023 p. At the time of admission, she complained of the appearance of swelling of the left lower limb, with an increase in the circumference of the latter to 8 cm in comparison with the opposite side. Diagnosis: lymphedema of the left lower limb of the III degree. In the anamnesis, moderately differentiated G2 adenocarcinoma of the uterine body pT1b pN0 cM0 stage Ib. Condition after extended extirpation of the uterus with appendages (2020). Condition after courses of radiation therapy, clinical group III. The patient was assessed for the condition of the lymphatic system of the left lower limb.Taking into account the examination results, the omentum with lymph nodes was transferred in the left inguinal area and revascularized. The patient was discharged on the 7th day after surgery. 6 months after the operation, during the examination and control measurements of the operated limb, we found out that , the limb had decreased by 3 cm in diameter all the way to the upper third of the lower leg.The final result should be evaluated in the remote postoperative period after 6 months, 12 months, 18 months and 24 months, which is why the patient’s next visit is scheduled for June assessment of long-term results continues.
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