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 - Publisher Copyright:
© 2017 Wiley Periodicals, Inc.
PY - 2017/11/1
Y1 - 2017/11/1
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 - lymph node flap transfer
KW - lymphaticovenular anastomosis
KW - lymphedema
KW - vascularized lymph node transfer
UR - http://www.scopus.com/inward/record.url?scp=85022322553&partnerID=8YFLogxK
U2 - 10.1002/jso.24730
DO - 10.1002/jso.24730
M3 - 文章
C2 - 28695707
AN - SCOPUS:85022322553
SN - 0022-4790
VL - 116
SP - 671
EP - 682
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
IS - 6
ER -