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Cheng MH, Loh CYY, Lin CY, et al.
Plastic and reconstructive surgery. Global open. Date of publication 2018 Dec 20;volume 6(12):e2056.
1. Plast Reconstr Surg Glob Open. 2018 Dec 20;6(12):e2056. doi: 10.1097/GOX.0000000000002056. eCollection 2018 Dec. Outcomes of Vascularized Lymph Node Transfer and Lymphovenous Anastomosis for Treatment of Primary Lymphedema. Cheng MH(1), Loh CYY(1), Lin CY(1). Author information: (1)Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Background: Primary lymphedema is a debilitating disease. This study was to investigate the outcomes between vascularized lymph node transfer (VLNT) and lymphovenous anastomosis (LVA) for treating primary lymphedema. Methods: Between January 2010 and December 2016, 17 patients with mean age of 31.5 ± 15.5 (ranged, 2-57) years diagnosed with 19 primary limb lymphedema were recruited. Patients with patent lymphatic ducts on indocyanine green lymphography were indicated for LVA, whereas those without patent lymphatic ducts were indicated for VLNT. Circumferential limb measurements, body weight, episodes of cellulitis and Lymphedema Quality-of-Life (LYMQoL) questionnaire were compared between preoperatively and postoperatively. Results: Fifteen lymphedematous limbs underwent VLNT (79%) and 4 underwent LVA (21%). All VLNT flaps survived. At a mean follow-up of 19.7 ± 8.5 months, mean reduction of limb circumference, body weight, and episodes of cellulitis were 3.7 ± 2.9 cm and 1.9 ± 2.9 cm (P = 0.2); 6.6 ± 5.9 kg and 1.7 ± 0.6 kg (P < 0.05); 5.1 ± 2.8 times/y and 4.2 ± 0.5 times/y in VLNT and LVA groups, respectively (P = 0.7). Improvements in overall score (from 3.9 ± 1.2 to 6.4 ± 1.1, P < 0.05) of the LYMQoL in VLNT group had statistical significant difference than that (from 3.0 ± 1.4 to 5.0 ± 2.4, P = 0.07) in LVA group. Conclusions: Both VLNT and LVA can effectively treat primary lymphedema patients. The reduction of above-knee circumference, body weight, episodes of cellulitis, and the improvement of LYMQoL was significantly greater in LVNT compared with LVA. DOI: 10.1097/GOX.0000000000002056 PMCID: PMC6326612 PMID: 30656125
Appears in following Topics:
Lymphedema - Surgical Management