<< Back to the abstract archive
Double level vascularized lymph node transfer utilizing the abdomen as a donor site for treatment of extremity lymphedema
Juan L Rendon, Michelle Coriddi, Daniel Eiferman, Roman Skoracki
The Ohio State University Wexner Medical Center
2018-02-14
Presenter: Juan L Rendon
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.
Director Name: Gregory Pearson
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema. Placement of the vascularized lymph node can be either proximal or distal on the extremity. We believe double level lymph vascularized node transfer (DL-VLNT) with both distal and proximal placement gives patients maximal benefit.
Methods: Two vascularized lymph node flaps were harvested from the abdomen in 5 patients. The jejunal mesenteric vascularized lymph node flap was harvested and transferred to the distal aspect of the extremity. A section of omentum was then harvested and transferred to the proximal area of the extremity. Etiology of lymphedema, surgical details, and results including subjective and objective data were analyzed for each patient and compared to single level lymph node transfer.
Results: The DL-VLNT was used in five patients for treatment of upper extremity lymphedema. Etiology included four patients with malignancy and one trauma patient. Three patients treated for malignancy had lymph node dissections, and three had radiation. All patients had subjective improvement in lymphedema. Of the five patients, four patients had pre-operative measurements and three had objective improvement in lymphedema. Compared to single level VLNT, more patients with DL-VLNT showed subjective improvement (100% vs 86%) and objective improvement (75% vs 60%).
Conclusions: DL-VLNT, using a jejunal mesenteric lymph node flap and an omentum flap, provides patients with maximum benefit. Using the abdomen as a donor site, there is a decreased risk of donor site lymphedema and allows for harvest of two flaps. DL-VLNT may be superior to single level VLNT.
