Tesis

Efektivitas Sedot Lemak Debulking pada Limfedema Ekstremitas Inferior Sekunder dengan Komposisi Dominan Lemak: Evaluasi Perbaikan Derajat Leg Dermal Backflow Menggunakan Limfografi Indocyanine Green = Effectiveness of Debulking Liposuction in Secondary Inferior Extremity Lymphedema with Predominant Fat Composition: Evaluation of the Degree of Leg Dermal Backflow Improvement Using Indocyanine Green Lymphography.

Latar belakang : Limfedema menimbulkan morbiditas yang memengaruhi kualitas hidup.1–4 Limfedema sekunder dengan komposisi dominan lemak tidak efektif ditatalaksanai dengan teknik fisiologis; hiperplasia lemak yang memerlukan reduksi (debulking) melalui prosedur sedot lemak. Sedot lemak debulking mengurangi lingkar ekstremitas dan memperbaiki aliran limfe. Penelitian ini ditujukan untuk mendapatkan bukti efektivitas perbaikan aliran limfatik melalui pemeriksaan limfografi indocyanine green. 7,9 Metode: Penelitian ini menerapkan desain studi kohort retrospektifdengan sampel pasien limfedema ekstremitas inferior sekunder dengan komposisi dominan lemak yang dilakukan sedot lemak debulking di Divisi Bedah Plastik Rekonstruksi dan Estetik Departemen Ilmu Bedah RSCM tahun 2022- Agustus 2024. Lingkar ekstemitas inferior dan derajat leg dermal backflow subjek sebelum dan sesudah sedot lemak debulking.merupakan variabel yang diteliti. Hasil: Lima belas subjek diikutsertakan pada penelitian ini. Lingkar ekstremitas inferior sebelum dan sesudah sedot lemak debulking menunjukkan penurunan bermakna lingkar ekstermitas inferior pada 10 cm di atas ankle, 25 cm di atas ankle, patela, 10 cm diatas lutut, 25 cm diatas lutut. Lima subjek dengan derajat leg dermal backflow IV dan 10 subjek dengan derajat dermal backflow V sebelum sedot lemak debulking. Lima subjek dengan derajat leg dermal backflow IV mengalami penurunaan bermakna derajat leg dermal backflow menjadi derajat II (1), III(4), 10 subjek dengan derajat leg dermal backflow V mengalami penurunaan derajat leg dermal backflow menjadi derajat IV (9). Kesimpulan: Sedot lemak debulking pada limfedema ekstremitas inferior sekunder dengan komposisi dominan lemak, menunjukan efektivitas mengurangi lingkar ekstremitas diikuti perbaikan aliran limfatik.
Kata kunci: Limfedema ekstremitas inferior sekunder, sedot lemak debulking, limfografi indocyanine green, leg dermal backflow


Background: Lymphedema causes morbidity that affects quality of life. 1 -4 Secondary lymphedema with a predominant composition of fat is not treated effectively with physiological techniques; Fat hyperplasia that requires reduction (debulking) through liposuction procedures. Debulking liposuction reduces extremity circumference and improves lymph flow. This study aims to obtain evidence of the effectiveness of improving lymphatic flow through indocyanine green lymphography examination. 7.9 Methods: This study implemented a retrospective cohort study design with a sample of secondary lower extremity lymphedema with a predominant composition of fat patients who underwent debulking liposuction in the Division of Reconstructive Plastic and Aesthetic Surgery, Department of Surgery, RSCM in 2022-August 2024. The subject's lower extremity circumference and degree of leg dermal backflow before and after debulking liposuction were the variables studied. Results: Fifteen subjects were included in this study. Inferior extremity circumference before and after debulking liposuction showed a significant reduction in inferior extremity circumference at 10 cm above the ankle, 25 cm above the ankle, patella, 10 cm above the knee, 25 cm above the knee. Five subjects had leg dermal backflow grade IV and 10 subjects had grade V dermal backflow before debulking liposuction. Five subjects with leg dermal backflow grade IV experienced a significant decrease in the degree of leg dermal backflow to grade II (1), III (4), 10 subjects with leg dermal backflow grade V experienced a decrease in the degree of leg dermal backflow to grade IV (9). Conclusion: Debulking liposuction in secondary lower extremity lymphedema with a predominant composition of fat shows effectiveness in reducing extremity circumference followed by improving lymphatic flow.
Key words: Secondary lower extremity lymphedema, debulking liposuction, indocyanine green lymphography, leg dermal backflow