Lymph Node Flap Based on the Right Transverse Cervical Artery as a Donor Site for Lymph Node Transfer

Sapountzis, Stamatis; Singhal, Dhruv; Rashid, Abid; Ciudad, Pedro; Meo, Domenico; Chen, Hung-Chi

doi:10.1097/sap.0000000000000422

Cited by 39 publications

(56 citation statements)

References 3 publications

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“…A modified technique of what was described by Chen et al 2,5,13,14 was used for the SLNF elevation. An elliptical skin flap was designed superior and parallel to the clavicle (►Fig.…”

Section: Vascularized Lymph Node Transfermentioning

confidence: 99%

Indocyanine Green Lymphographic Evidence of Surgical Efficacy Following Microsurgical and Supermicrosurgical Lymphedema Reconstructions

Chen

Zhao

Yamamoto

et al. 2016

J reconstr Microsurg

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Microsurgical vascularized lymph node transfer (VLNT) and supermicrosurgical lymphaticovenular anastomosis (LVA) are increasingly performed to treat lymphedema. The surgical outcome is commonly assessed by volume-based measurement (VBM), a method that is not consistently reliable. We describe indocyanine green (ICG) lymphography as an alternative postoperative tracking modality after lymphatic reconstruction with VLNT and LVA. VLNT and LVA were performed in patients with therapy-refractory lymphedema. Patients were evaluated qualitatively by clinical assessment, quantitatively with VBM, and lymphographically using ICG lymphography. The evaluation was performed preoperatively, and at 3, 6, and 12-month postoperatively. Overall, 21 patients underwent lymphatic reconstruction with either VLNT or LVA. All reported prompt and durable relief of symptoms during the study period. All experienced disease regression based on the Campisi criteria. Out of the 21 patients, 20 (95%) demonstrated lymphographic down staging of disease severity. Out of the 21 patients, 3 (14%) developed a paradoxical increase in limb volume based on VBM despite clinical improvement. ICG lymphography correlated highly with patient self-assessment and clinical examination, and is an effective postoperative tracking modality after lymphatic reconstruction.

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“…A modified technique of what was described by Chen et al 2,5,13,14 was used for the SLNF elevation. An elliptical skin flap was designed superior and parallel to the clavicle (►Fig.…”

Section: Vascularized Lymph Node Transfermentioning

confidence: 99%

Indocyanine Green Lymphographic Evidence of Surgical Efficacy Following Microsurgical and Supermicrosurgical Lymphedema Reconstructions

Chen

Zhao

Yamamoto

et al. 2016

J reconstr Microsurg

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“…Vascularized lymph node (VLN) transfer (VLNT) is a useful surgical option for patients with advanced‐stage lymphedema (Basta, Gao, & Wu, ; Chang, Masia, Garza, Skoracki, & Neligan, ; Granzow, Soderberg, Kaji, & Dauphine, ; Scaglioni et al, ; Tourani, Taylor, & Ashton, ). Although several donor sites and techniques have been proposed, there is no standard method of treatment (Barreiro et al, ; Cheng et al, ; Ciudad et al, ; Ito, Lin, & Cheng, ; Koshima et al, ; Mardonado, Chen, & Chang, 2016; Sapountzis et al, ). In most studies, 1 VLN that includes a few lymph nodes was elevated from a single healthy donor site and transferred to a single recipient site on the affected limb without lymphatic anastomosis.…”

Section: Introductionmentioning

confidence: 99%

Improvement of the efficacy of vascularized lymph node transfer for lower‐extremity lymphedema via a prefabricated lympho‐venous shunt through lymphaticovenular anastomosis between the efferent lymphatic vessel and small vein in the elevated vascularized lymph node

et al. 2017

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“…There are also reports that the TCA may arise as a branch of the internal mammary artery. 39 The surgeon must be able to adjust the approach accordingly to ensure blood supplies to the lymph nodes are preserved during the dissection. Additionally, there are many vital structures in the supraclavicular region including the carotid artery, internal jugular vein, thoracic duct, and phrenic nerve.…”

Section: Supraclavicular Flapmentioning

confidence: 99%

Vascularized Lymph Node Transfer for Lymphedema

Schaverien

Badash

Patel

et al. 2018

Seminars in Plastic Surgery

112

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Advances in our understanding of the lymphatic system and the pathogenesis of lymphedema have resulted in the development of effective surgical treatments. Vascularized lymph node transfer (VLNT) involves the microvascular transplantation of functional lymph nodes into an extremity to restore physiological lymphatic function. It is most commonly performed by transferring combined deep inferior epigastric artery perforator and superficial inguinal lymph node flaps for postmastectomy breast reconstruction. For patients who do not require or are unable to undergo free abdominal breast reconstruction or have lymphedema affecting the lower extremity, several other VLNT options are available. These include flaps harvested from within the axillary, inguinal, or cervical lymph node basins, and lymph node flaps from within the abdominal cavity. This article reviews the lymph node flap options and techniques available for VLNT for lymphedema.

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Lymph Node Flap Based on the Right Transverse Cervical Artery as a Donor Site for Lymph Node Transfer

Cited by 39 publications

References 3 publications

Indocyanine Green Lymphographic Evidence of Surgical Efficacy Following Microsurgical and Supermicrosurgical Lymphedema Reconstructions

Indocyanine Green Lymphographic Evidence of Surgical Efficacy Following Microsurgical and Supermicrosurgical Lymphedema Reconstructions

Improvement of the efficacy of vascularized lymph node transfer for lower‐extremity lymphedema via a prefabricated lympho‐venous shunt through lymphaticovenular anastomosis between the efferent lymphatic vessel and small vein in the elevated vascularized lymph node

Vascularized Lymph Node Transfer for Lymphedema

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