Cheng MH, Loh CYY, Lin CY, et al.
Plastic and reconstructive surgery. Global open. Date of publication 2018 Dec 20;volume 6(12):e2056.
1. Plast Reconstr Surg Glob Open. 2018 Dec 20;6(12):e2056. doi:
10.1097/GOX.0000000000002056. eCollection 2018 Dec.
Outcomes of Vascularized Lymph Node Transfer and Lymphovenous Anastomosis for
Treatment of Primary Lymphedema.
Cheng MH(1), Loh CYY(1), Lin CY(1).
Author information:
(1)Division of Reconstructive Microsurgery, Department of Plastic and
Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang
Gung University, Taoyuan, Taiwan.
Background: Primary lymphedema is a debilitating disease. This study was to
investigate the outcomes between vascularized lymph node transfer (VLNT) and
lymphovenous anastomosis (LVA) for treating primary lymphedema.
Methods: Between January 2010 and December 2016, 17 patients with mean age of
31.5 ± 15.5 (ranged, 2-57) years diagnosed with 19 primary limb lymphedema were
recruited. Patients with patent lymphatic ducts on indocyanine green lymphography
were indicated for LVA, whereas those without patent lymphatic ducts were
indicated for VLNT. Circumferential limb measurements, body weight, episodes of
cellulitis and Lymphedema Quality-of-Life (LYMQoL) questionnaire were compared
between preoperatively and postoperatively.
Results: Fifteen lymphedematous limbs underwent VLNT (79%) and 4 underwent LVA
(21%). All VLNT flaps survived. At a mean follow-up of 19.7 ± 8.5 months, mean
reduction of limb circumference, body weight, and episodes of cellulitis were
3.7 ± 2.9 cm and 1.9 ± 2.9 cm (P = 0.2); 6.6 ± 5.9 kg and 1.7 ± 0.6 kg (P <
0.05); 5.1 ± 2.8 times/y and 4.2 ± 0.5 times/y in VLNT and LVA groups,
respectively (P = 0.7). Improvements in overall score (from 3.9 ± 1.2 to
6.4 ± 1.1, P < 0.05) of the LYMQoL in VLNT group had statistical significant
difference than that (from 3.0 ± 1.4 to 5.0 ± 2.4, P = 0.07) in LVA group.
Conclusions: Both VLNT and LVA can effectively treat primary lymphedema patients.
The reduction of above-knee circumference, body weight, episodes of cellulitis,
and the improvement of LYMQoL was significantly greater in LVNT compared with
LVA.
DOI: 10.1097/GOX.0000000000002056
PMCID: PMC6326612
PMID: 30656125
