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Cadaveric Analysis of the Omental Lymph Node Flap
Naveed Nosrati MD, Alex Mann MD, Juan Socas MD
Indiana University
2018-01-31
Presenter: Naveed Nosrati
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal o
Director Name: William Wooden
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Lymphedema can be a very debilitating disease, and with an increasing nationwide prevalence has become a more serious public health issue. Traditional treatments consist of symptom management with compression or surgical debulking that don't address the underlying cause. Recently, lymph node transfer has become a viable option. Though these transfers may cause donor site. The gastroepiploic nodal basin of the omental lymph node flap has been shown to avoid this complication. It has also been theorized that multiple level transfers will provide better outcomes. In this study, we analyze the number of nodes per region in this nodal basin and their distribution.
Cadaveric dissection was performed on two different occasions. The right gastroepiploic vessels were first identified and the omentum released from the transverse colon. The short gastric vessels were then divided and the flap was released from the stomach. Finally the left gastroepiploic vessels were divided and the flap was removed. The flap were measured and sectioned into thirds. Gross only node identification was performed on the first dissection, while microscopic and gross evaluation was performed on the second set.
Nine total cadavers were dissected, but one from each group was unusable. The average flap was 19.36cm long and 3.0cm wide. The proximal third contained 3.57 nodes, the middle third 1.71 nodes, and distal 0.86 nodes.
The omental lymph node flap provides donor lymph nodes throughout its entire length including the distal third. This data shows the flap may be used for a bi-level lymph node transfer.
