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

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.

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

“…Excisional procedures, such as suction‐assisted lipectomy (SAL), radical reduction with preservation of perforators (RRPPs), and the Charles’ procedure, aim to decrease the lymphatic load in the advanced stages by removing the diseased tissue. However, physiologic and excisional procedures have a common goal: to improve the limb size, decrease the incidence of cellulitis, and thus improve patient’s quality of life …”

“…During the last decade, our unit has explored different surgical techniques in VLNT surgery . We have extensively applied and published on various VLNTs used . During a period of 7 years, the gastroepiploic VLNT has given us the most favorable results and has become our flap of choice for the treatment of upper and lower extremity lymphedema based on the reported clinical outcomes, reasonable length of hospital stay, and low donor site morbidity …”

Comprehensive multimodal surgical treatment of end‐stage lower extremity lymphedema with toe management: The combined Charles,’ Homan’s, and vascularized lymph node transfer (CHAHOVA) procedures

“…The difference was statistically significant, however, the study did not report on the infection rate. In another study, a subgroup of 36 patients with ISL stage III both upper and LEL was treated with VLNT . The mean CRR was 17.9% and the infectious episodes, while decreased, were not completely eliminated.…”

“…To limit the operative time, the excisional components of the operation, and harvest of the (VLNF) were performed simultaneously by two different teams. The VLNF of choice has changed over the years . Initially, the groin VLNF was used.…”

“…Initially, the groin VLNF was used. However, due to concerns for donor‐site lymphedema, there was a transition to the supraclavicular VLNF . Lately, because of its unique advantages (high lymph node content, minimal donor site morbidity, avoidance of donor site lymphedema, and concealed scars), the laparoscopically harvested gastroepiploic VLNF has become our flap of choice .…”