A head‐to‐head comparison among donor site morbidity after vascularized lymph node transfer: Pearls and pitfalls of a 6‐year single center experience

Abstract

Between 2010 and 2016, 110 patients with extremity lymphedema underwent vascularized lymph node (VLN) transfer: groin (G-VLN = 20), supraclavicular (SC-VLN = 54), and right gastroepiploic (RGE-VLN = 36) open and laparoscopic approach. Herein, we discuss the pearls and pitfalls for VLN harvest and compare donor site morbidity and complications. Lymphatic leakage: G-VLN (n = 1) and SC-VLN (n = 1) and one hematoma: SC-VLN were found. Laparoscopic harvest of the RGE-VLN reduces donor site morbidity. However, surgeons experience is imperative to minimize donor site morbidity and complications. J. Surg. Oncol. 2017;115:37-42. © 2016 Wiley Periodicals, Inc.

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

“…Previously, we evaluated donor site morbidity in a large series of patient who underwent VLNT . In the current series, two major complications were encountered, one flap loss and one hematoma.…”

“…Currently, we consider the GE‐VLN as the flap of choice for the treatment of upper and lower extremity lymphedema based on the favorable clinical outcomes, reasonable length of hospital stay, absence of risk for iatrogenic lymphedema, and low donor site morbidity (especially when flap is harvested by laparoscopic techniques) . However, when the GE‐VLN is not available, we resort to other donor sites on an individual basis.…”

Combined double vascularized lymph node transfers and modified radical reduction with preservation of perforators for advanced stages of lymphedema

“…Regarding VLNT, various donor site options have been described for lymph node flap harvest such as the groin, submental, supraclavicular, lateral thoracic, gastroepiploic, jejunal, appendicular, and ileocecal areas . Although there have been satisfactory results with all VLNTs described in the literature, there are still some concerns regarding recipient and donor site morbidity, and iatrogenic lymphedema after the lymph node harvest . At this time, the ideal lymph node flap has not been determined.…”

“…During the last decade, our unit has explored different surgical techniques in VLNT surgery . We have searched for the least invasive technique that minimizes donor site morbidity, avoids iatrogenic lymphedema, reduces the number of complications, and maximizes the efficacy of the procedure.…”

“…We have searched for the least invasive technique that minimizes donor site morbidity, avoids iatrogenic lymphedema, reduces the number of complications, and maximizes the efficacy of the procedure. Currently, we consider the gastroepiploic lymph node flap to be the flap of choice for the treatment of upper and lower extremity lymphedema based on the favorable clinical outcomes, reasonable length of hospital stay, and low donor site morbidity with no instances of iatrogenic lymphedema …”