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Lymphaticovenous Bypass for Lymphedema Prevention in Melanoma Patients
Cagri Cakmakoglu, MD, Grzegorz J. Kwiecien, MD, Graham S. Schwarz, MD, FACS Brian Gastman, MD
Cleveland Clinic
2019-02-15
Presenter: Cagri Cakmakoglu, MD
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: Graham Schwarz,MD
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background
Extremity lymphedema is a feared sequela of axillary or ilioinguinal lymph node dissection (LND). In traditional lymph node dissection, no effort is made to preserve or restore upper or lower extremity lymphatic flow. We hypothesized that prophylactic lymphatico-venous bypass (LVB) could be a reproducible technique to preserve functional lymphatic flow following axillary and ilioinguinal LND in melanoma patients. This study reports the first prophylactic LVB in melanoma patients undergoing complete LND for gross metastatic disease.
Methods
We present a case series of ten patients with malignant melanoma who had axillary or ilioinguinal LND for bulky regional involvement and who underwent prophylactic LVB. Details of the surgical procedure, common pitfalls, as well as indications are discussed.
Results
This technique is reproducible as we have successfully completed this procedure in all 15 consecutive cases.
Conclusions
Restoration of lymphatic flow following axillary or ilioinguinal LND in melanoma patients represents a new approach that may decrease the burden of iatrogenic extremity lymphedema.
