Lower limb lymphedema patients can still benefit from supermicrosurgical lymphaticovenous anastomosis (Lva) after vascularized lymph node flap transfer (vlnt) as delayed lymphatic reconstruction—a retrospective cohort study

Johnson Chia Shen Yang*, Shao Chun Wu, Akitatsu Hayashi, Wei Che Lin, Gong Kai Huang, Pei Yu Tsai, Peng Chen Chien, Ching Hua Hsieh

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

10 Scopus citations

Abstract

Background: For lymphedema patients who received a vascularized lymph node flap transfer (VLNT) as their primary treatment, what are the treatment options when they seek further im-provement? With recent publications supporting the use of lymphaticovenous anastomosis (LVA) for treating severe lymphedema, we examined whether LVA could benefit post-VLNT patients seeking further improvement. Methods: This retrospective cohort study enrolled eight lymphedema patients with nine lymphedematous limbs (one patient suffered from bilateral lower limb lymphedema) who had received VLNT as their primary surgery. Patients with previous LVA, liposuction, excisional ther-apy, or incomplete data were excluded. LVA was performed on nine lower lymphedematous limbs. Demographic data and intraoperative findings were recorded. Preoperative and postoperative limb volumes were measured with magnetic resonance volumetry. The primary outcome was the limb volume measured 6 months post-LVA. Results: The median duration of lymphedema before LVA was 10.5 (4.9–15.3) years. The median waiting time between VLNT and LVA was 41.4 (22.3–97.9) months. The median volume gained in the lymphedematous limb was 3836 (2505–4584) milliliters (mL). The median post-LVA follow-up period was 18 (6–30) months. Significant 6-month and 1-year post-LVA percentage volume reductions were found compared to pre-LVA volume (both p < 0.001). Conclusion: Based on the results from this study, the authors recommend the use of LVA as a secondary procedure for post-VLNT patients seeking further improvement.

Original languageEnglish
Article number3121
JournalJournal of Clinical Medicine
Volume10
Issue number14
DOIs
StatePublished - 02 07 2021

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

  • Lymphaticovenous anastomosis
  • Lymphedema
  • Lymphovenous bypass
  • Supermicro-surgery
  • Vascularized lymph node transfer

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