{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T04:39:53Z","timestamp":1785559193626,"version":"3.56.0"},"reference-count":76,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Das Lymph\u00f6dem der oberen Extremit\u00e4t nach Mammakarzinom\n                    f\u00fchrt unbehandelt durch chronisch-progredienten Gewebeumbau zu\n                    signifikanten Einschr\u00e4nkungen von Lebensqualit\u00e4t und Funktion,\n                    und kann mit Latenzzeit noch Jahre nach der initialen Tumorbehandlung auftreten.\n                    Sowohl die alleinige autologe Brustrekonstruktion als auch die lymphatische\n                    Chirurgie zur Behandlung des Lymph\u00f6dems sind wirksam bei der Reduktion\n                    von Volumen, und Umfang sowie funktionellen Beeintr\u00e4chtigungen und\n                    verbessern die lokale Immunkompetenz, K\u00f6rperbild und -integrit\u00e4t\n                    sowie Lebensqualit\u00e4t. Physiologische Verfahren, einschlie\u00dflich\n                    lymphoven\u00f6ser Anastomsosen (LVA) und vaskularisierte\n                    Lymphknotentransplantation (VLKT), adressieren die Neuordnung und Optimierung\n                    des Lymphabstroms innerhalb der betroffenen Extremit\u00e4t. Bei Patientinnen\n                    mit Mammakarzinom-assoziiertem Lymph\u00f6dem nach Ablatio und geplantem\n                    Brustaufbau bietet die autologe Brustrekonstruktion in Verbindung mit\n                    lymphatischer Mikrochirurgie durch VLKT, LVA oder die Kombination beider\n                    Verfahren die Option der ganzheitlichen und einzeitigen Wiederherstellung. Die\n                    lokale Narbenl\u00f6sung in der Axilla ist Teil des chirurgischen Konzepts\n                    f\u00fcr die Rekrutierung von Armlymphkollektoren und Vorbereitung des\n                    Empf\u00e4ngerbetts des VLK Transplanats. In diesem Artikel werden die\n                    Indikationen, die pr\u00e4operative Diagnostik, die Operationstechnik, die\n                    Ergebnisse sowie Tipps und Tricks zur Durchf\u00fchrung der Kombination als\n                    auch der einzelnen Verfahren dargestellt.<\/jats:p>","DOI":"10.1055\/a-1868-5527","type":"journal-article","created":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T22:36:46Z","timestamp":1660084606000},"page":"326-338","source":"Crossref","is-referenced-by-count":1,"title":["Autologe Brustrekonstruktion und lymphorekonstruktive Chirurgie\n                    nach Mastektomie bei Mammakarzinom-assoziiertem Lymph\u00f6dem"],"prefix":"10.1055","volume":"54","author":[{"given":"Christoph","family":"Hirche","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Plastische, Hand- und Rekonstruktive\n                    Mikrochirurgie, Handtrauma- und Replantationszentrum, BG Unfallklinik Frankfurt\n                    am Main, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,8,9]]},"reference":[{"key":"ref1","volume-title":"Mortality from cancer Health at a Glance: Europe 2014","author":"Organisation for Economic Co-operation and\n                    Development","year":"2014"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"E359","DOI":"10.1002\/ijc.29210","article-title":"Cancer incidence and mortality worldwide: sources, methods and major patterns in\n                    GLOBOCAN 2012","volume":"136","author":"J Ferlay","year":"2015","journal-title":"Int J Cancer"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12282-013-0497-8","article-title":"Lymph node ratio and breast cancer prognosis: a meta-analysis","volume":"21","author":"D Liu","year":"2014","journal-title":"Breast Cancer"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"76","DOI":"10.5152\/ejbh.2019.4414","article-title":"Impact of Number of Positive Lymph Nodes and Lymph Node Ratio on Survival of\n                    Women with Node-Positive Breast Cancer","volume":"15","author":"F Tonellotto","year":"2019","journal-title":"Eur J Breast Health"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s11764-012-0247-5","article-title":"Quality of life among breast cancer patients with lymphedema: a systematic\n                    review of patient-reported outcome instruments and outcomes","volume":"7","author":"A L Pusic","year":"2013","journal-title":"J Cancer Surviv"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1056\/NEJMcp1803290","article-title":"Lymphedema after Breast Cancer Treatment","volume":"379","author":"S G Rockson","year":"2018","journal-title":"N Engl J Med"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s10549-010-0760-z","article-title":"ICG fluorescence-guided sentinel node biopsy for axillary nodal staging in\n                    breast cancer","volume":"121","author":"C Hirche","year":"2010","journal-title":"Breast Cancer Res Treat"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/j.crad.2017.06.121","article-title":"Preoperative sentinel lymph node identification, biopsy and localisation using\n                    contrast enhanced ultrasound (CEUS) in patients with breast cancer: a systematic\n                    review and meta-analysis","volume":"72","author":"A Nielsen Moody","year":"2017","journal-title":"Clin Radiol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/S1470-2045(18)30380-2","article-title":"Axillary dissection versus no axillary dissection in patients with breast cancer\n                    and sentinel-node micrometastases (IBCSG 23-01): 10-year follow-up of a\n                    randomised, controlled phase 3 trial","volume":"19","author":"V Galimberti","year":"2018","journal-title":"Lancet Oncol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1093\/qjmed\/hcg126","article-title":"Lymphoedema: an underestimated health problem","volume":"96","author":"C J Moffatt","year":"2003","journal-title":"QJM"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1089\/lrb.2018.29053.sr","article-title":"Diagnosis of Early and Subclinical Lymphedema Following Breast Cancer","volume":"16","author":"S G Rockson","year":"2018","journal-title":"Lymphat Res Biol"},{"key":"ref14","first-page":"515","article-title":"Sequelae of axillary dissection vs. axillary sampling with or without\n                    irradiation for breast cancer. 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