Comparison of long-term clinical outcomes among different vascularized lymph node transfers: 6-year experience of a single center's approach to the treatment of lymphedema

Pedro Ciudad, Mouchammed Agko, John Jaime Perez Coca, Oscar J Manrique, Wei-Ling Chang, Fabio Nicoli, Shih-Heng Chen, Hung-Chi Chen

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

BACKGROUND: This study evaluated the long-term clinical outcomes among different vascularized lymph node transfers (VLNT) used at our institution.

METHODS: Between July 2010 and July 2016, all patients with International Society of Lymphology (ISL) stages II-III who underwent VLNT were evaluated. Demographic and clinical data (limb circumference, infectious episodes, lymphoscintigraphic studies) were recorded pre-operatively. Clinical outcomes, complications, and additional excisional procedures were analyzed post-operatively. At least 2-year follow-up was required for inclusion.

RESULTS: Overall, 83 patients (Stage II:47, Stage III:36) met the inclusion criterion. Mean follow-up was 32.8 months (range, 24-49). Lymph node flaps used were groin (n = 13), supraclavicular (n = 25), gastroepiploic (n = 42), ileocecal (n = 2), and appendicular (n = 1). Total mean circumference reduction rate was 29.1% (Stage II) and 17.9% (Stage III) (P < 0.05). A paired t-test showed that VLNT significantly decreased the number of infections (P < 0.05). Three patients reported no improvement of the symptoms. Major complications included one flap loss and one donor site hematoma. After the period of follow-up, 18 patients (21.7%) underwent additional excisional procedures.

CONCLUSION: VLNT is a promising technique used for the treatment of lymphedema and appears to be more effective in moderate stages (Stage II). Patients with advanced stage lymphedema (Stage III) may benefit from additional excisional procedures.

Original languageEnglish (US)
Pages (from-to)1346-1347
Number of pages12
JournalJournal of Surgical Oncology
Volume116
Issue number6
DOIs
StatePublished - Nov 2017
Externally publishedYes

Keywords

  • Adult
  • Aged
  • Extremities/diagnostic imaging
  • Female
  • Humans
  • Lymph Nodes/blood supply
  • Lymphedema/diagnostic imaging
  • Lymphoscintigraphy
  • Male
  • Middle Aged
  • Retrospective Studies
  • Surgical Flaps
  • Treatment Outcome

ASJC Scopus subject areas

  • Surgery
  • Oncology

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