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

11 Citations (Scopus)

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

Fingerprint

Lymphedema
Lymph Nodes
Therapeutics
Groin
Hematoma
Extremities
Demography
Tissue Donors
Infection

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

Cite this

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

In: Journal of Surgical Oncology, Vol. 116, No. 6, 11.2017, p. 1346-1347.

Research output: Contribution to journalArticle

Ciudad, Pedro ; Agko, Mouchammed ; Perez Coca, John Jaime ; Manrique, Oscar J ; Chang, Wei-Ling ; Nicoli, Fabio ; Chen, Shih-Heng ; Chen, Hung-Chi. / 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. In: Journal of Surgical Oncology. 2017 ; Vol. 116, No. 6. pp. 1346-1347.
@article{fef8dcf80d264b90b0aa39c369f58248,
title = "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",
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.",
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",
author = "Pedro Ciudad and Mouchammed Agko and {Perez Coca}, {John Jaime} and Manrique, {Oscar J} and Wei-Ling Chang and Fabio Nicoli and Shih-Heng Chen and Hung-Chi Chen",
note = "{\circledC} 2017 Wiley Periodicals, Inc.",
year = "2017",
month = "11",
doi = "10.1002/jso.24730",
language = "English (US)",
volume = "116",
pages = "1346--1347",
journal = "Journal of Surgical Oncology",
issn = "0022-4790",
publisher = "Wiley-Liss Inc.",
number = "6",

}

TY - JOUR

T1 - Comparison of long-term clinical outcomes among different vascularized lymph node transfers

T2 - 6-year experience of a single center's approach to the treatment of lymphedema

AU - Ciudad, Pedro

AU - Agko, Mouchammed

AU - Perez Coca, John Jaime

AU - Manrique, Oscar J

AU - Chang, Wei-Ling

AU - Nicoli, Fabio

AU - Chen, Shih-Heng

AU - Chen, Hung-Chi

N1 - © 2017 Wiley Periodicals, Inc.

PY - 2017/11

Y1 - 2017/11

N2 - 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.

AB - 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.

KW - Adult

KW - Aged

KW - Extremities/diagnostic imaging

KW - Female

KW - Humans

KW - Lymph Nodes/blood supply

KW - Lymphedema/diagnostic imaging

KW - Lymphoscintigraphy

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Surgical Flaps

KW - Treatment Outcome

UR - http://www.scopus.com/inward/record.url?scp=85048858534&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048858534&partnerID=8YFLogxK

U2 - 10.1002/jso.24730

DO - 10.1002/jso.24730

M3 - Article

C2 - 28695707

VL - 116

SP - 1346

EP - 1347

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

IS - 6

ER -