Assessment of postmastectomy lymphedema and current treatment approaches

Lenfödem; lenfatik dolaşım sisteminde malformasyon veya kazanılmış bozukluklara bağlı olarak ortaya çıkan, intertisyel hücre boşluklarında proteinden zengin sıvının birikmesidir. Mastektomi sonrası hastaların önemli bir kısmında üst ekstremite lenfö- demi gelişmektedir. Günümüzde, lenfödem tedavisinde uluslararası tedavi yaklaşımı olarak kompleks dekonjestif fizik tedavi önerilmektedir. Kompleks dekonjestif fizik tedavi, cilt bakımı, manuel lenfatik drenaj, kompresyon bandajı, kompresyon giysisi, egzersiz ve intermittent pnömotik kompresyon pompası uygulamalarını içerir. Konservatif tedaviye cevap alınamadığı hastalarda alternatif olarak cerrahi müdahaleler de yapılmaktadır. Bu derlemede postmastektomi lenfödeminde güncel tedavi yaklaşımları tartışılmıştır.

Postmastektomi lenfödeminin değerlendirilmesi ve güncel tedavi yaklaşımları

Lymphedema can be defined as the abnormal accumulation of protein-rich interstitial fluid that occurs primarly as a consequence of malformation or acquired distruption of the lymphatic circulation. Upper extremity lymphedema can develop in a significant proportion of patients after mastectomy. Currently, complex decongestive physical therapy is accepted as international stan- dard treatment approach for the treatment of lymphedema. Complex decongestive physical therapy includes skin care, manual lymphatic drainage, compression bandage, compression garments, exercise and sometimes addition of intermittent pneumatic compression pump. When conservative treatments is not sufficient surgical intervention is an alternative to the patients. In this review, current treatment approaches are discussed.

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