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首页> 外文期刊>Tumori. >Evaluation of lymphatic compensation by lymphoscintigraphy in the postoperative period of breast cancer surgery with axillary dissection.
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Evaluation of lymphatic compensation by lymphoscintigraphy in the postoperative period of breast cancer surgery with axillary dissection.

机译：乳腺癌伴腋窝淋巴清扫术术后的淋巴造影对淋巴补偿的评估。

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OBJECTIVE: To evaluate postoperative lymphatic compensation in the upper limb after mastectomy with axillary dissection. SUBJECTS AND METHODS: Twenty-three patients who underwent lymphoscintigraphy before and 60 days after surgery were enrolled from September 2006 to June 2007, in Campinas, Brazil. Protocol examination consisted in static imaging of each upper limb in semi-flexion and thoracic imaging after 10 min and 1 and 2 hr after subcutaneous injection of 1 mCi (37 MBq) of 99mTc dextran into the dorsum of the hand. A comparative analysis was made of hepatic uptake of the radiopharmaceutical, velocity of axillary lymph node visualization (I, visible at 10 min; II, at 1 hr; III, at 2 hr; IV, not visible) and degree (intensity) of uptake (a, marked; b, moderate; c, mild; d, absent) before and 60 days after surgery. RESULTS: In the preoperative period, 3 (13%) patients were considered to have an optimal pattern (Ia) and 2 (9%) showed total involvement (IVd). Compared to velocity in the postoperative period, 9 (39%) patients showed no difference, 5 (22%) improved, 9 (39%) became worse, and one was considerably worse. Regarding the degree, 10 (43%) patients showed no difference, 9 (39%) became worse, and 4 (17%) improved. Regarding classification, 2 (9%) patients had an optimal lymphatic pattern (Ia) and 3 (13%) had total involvement (IVd). No patient presented decreased hepatic uptake after surgical treatment. CONCLUSIONS: The study found relevant changes in preoperative and postoperative lymphoscintigraphy, demonstrating the existence of functional differences in the lymphatic system of the upper limb. Alterations in lymphatic drainage pattern may already be perceived 60 days postoperatively, as can signs of lymphovenous anastomoses.
机译：目的：评估腋窝淋巴结清扫术后上肢的淋巴补偿。研究对象和方法：2006年9月至2007年6月在巴西坎皮纳斯市入组的23例术前和术后60天接受了淋巴闪烁成像的患者。协议检查包括在皮下注射1 mCi（37 MBq）的99mTc右旋糖酐至手背10分钟，1、2小时后，对半屈曲的每个上肢进行静态成像，并对胸部成像。对肝对放射性药物的摄取，腋窝淋巴结可视化的速度（I，在10分钟处可见; II，在1小时处; III，在2小时处; IV，不可见）和摄取程度（强度）进行比较分析。 （a，标记; b，中度; c，轻度; d，缺失）手术前和手术后60天。结果：在术前，3例（13％）患者被认为具有最佳模式（Ia），2例（9％）表现为完全受累（IVd）。与术后速度相比，有9例（39％）患者无差异，有5例（22％）好转，有9例（39％）恶化，有1例明显恶化。关于程度，有10例（43％）患者没有差异，有9例（39％）恶化，有4例（17％）改善。关于分类，有2名（9％）的患者具有最佳的淋巴模式（Ia），有3名（13％）的患者具有完全受累（IVd）。手术治疗后无患者肝吸收减少。结论：该研究发现术前和术后淋巴闪烁显像术均发生了相关变化，表明上肢淋巴系统存在功能差异。术后60天可能已经感觉到淋巴引流方式的改变，淋巴静脉吻合的迹象也可以看到。

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