3 years ago

Manejo del linfedema secundario a cáncer de mama empleando terapia descongestiva compleja con presoterapia multicompartimental secuencial. Experiencias en una unidad de linfedema

M. Rodríguez Manso, R. Martín Mourelle, S. Otero Villaverde, E. Canosa Hermida

Publication date: Available online 18 May 2018

Source: Rehabilitación

Author(s): M. Rodríguez Manso, R. Martín Mourelle, S. Otero Villaverde, E. Canosa Hermida

Resumen
Objetivo

El protocolo de tratamiento para los pacientes con linfedema sigue siendo controvertido. El objetivo de este trabajo es analizar el resultado de la Terapia Descongestiva Compleja con presoterapia multicompartimental secuencial aplicada por primera vez a pacientes con linfedema secundario a cáncer de mama en una Unidad de Linfedema.

Material y métodos

Este estudio observacional con seguimiento retrospectivo está basado en la revisión de historias clínicas durante el periodo 2013-2016. 48 pacientes reunieron los criterios de inclusión de: diagnóstico de linfedema secundario a cáncer de mama, realizar por primera vez sesiones completas de Terapia Descongestiva Compleja (con drenaje linfático manual, presoterapia multicompartimental secuencial y vendaje multicapas) haber realizado la toma de medidas y firmar el consentimiento informado. La valoración se realizó comparando las medidas en centímetros del perímetro del miembro tratado y el contralateral en 7 niveles en 3 momentos (inicial, postratamiento y en la revisión) usando la fórmula de Kuhnke para obtener los volúmenes aproximados.

Resultados

La diferencia entre los volúmenes de ambos miembros bajó desde el 21,61% de media inicial, al 15,98% a corto plazo y al 15,64% a medio plazo, consiguiéndose bajada de volumen en 39 de los pacientes y bajada del grado de linfedema en 21 de ellos.

Conclusiones

Los resultados avalan la elección de la Terapia Descongestiva Compleja con presoterapia multicompartimental secuencial como tratamiento estándar en el linfedema secundario a cáncer de mama. Es necesaria más investigación con estudios objetivables y reproducibles que incluyan resultados a largo plazo.

Abstract
Objective

The optimal treatment protocol for lymphoedema patients is still controversial. Therefore, the aim of this study was to analyse the results of Complex Decongestive Therapy with intermittent multi-chamber pneumatic compression applied for the first time in patients with breast cancer-related lymphoedema in a Lymphoedema Unit.

Material and methods

This retrospective observational study was based on a review of medical records from 2013-2016. A total of 48 patients met the inclusion criteria, ie, those who had received a diagnosis of breast cancer-related lymphoedema, had undergone complete sessions of Complex Decongestive Therapy (with manual lymphatic drainage, intermittent multi-chamber pneumatic compression and multi-layer bandaging) for the first time, had available recorded measurements and had signed an informed consent form. The assessment was conducted by comparing the measurement in centimetres of the circumference of the affected limb with the contralateral measurements at 7 levels in 3 time intervals (initial, post-treatment and at the medical follow-up). The Kuhnke method was used to obtain the approximate volumes.

Results

The difference between the volumes of the two limbs decreased from an initial mean of 21.61%, to 15.98% in the short-term and 15.64% in the medium-term, so there was a volume reduction in 39 patients. Moreover, the stage of lymphoedema decreased in 21 of them.

Conclusions

The results support the choice of Complex Decongestive Therapy with intermittent multi-chamber pneumatic compression as a standard treatment in breast cancer-related lymphoedema. Further research is required on this issue with measurable and reproducible studies that include long-term-results.

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