Outcomes of Vascularized Lymph Node Transfer Treatment in Patients with Lymphedema

Abstract

Objective: This study aimed to evaluate the postoperative outcomes of patients with lymphedema treated with vascularized lymph node transfer (VLNT). Materials and Methods: A retrospective chart review was conducted on 28 patients who underwent VLNT procedures at Siriraj Hospital between 2010 and 2020. Data collected included patient demographics, underlying diseases, previous cancer treatments, duration of lymphedema, etiology of lymphedema, donor and recipient sites, operative time, and limb circumference measurements were taken pre-operatively and at 1, 3, 6, and 12 months postoperatively. Additionally, postoperative complications were documented and analyzed. Results: The review identified various underlying diseases associated with lymphedema, mostly linked to cancer. Noteworthy cancer treatments included node dissection, radiotherapy, and chemotherapy. The etiology of lymphedema varied, with multiple donor and recipient sites used for VLNT procedures. Postoperative limb circumference measurements showed significant percentage reduction in limb circumference, particularly in patients with upper limb lymphedema (p<0.05), while the lower limb showed no statistical significance. Postoperative complications included flap necrosis, flap congestion, flap hematoma, and cellulitis. Conclusion: Our retrospective analysis underscores the effectiveness of VLNT procedures in managing lymphedema at Siriraj Hospital. Despite the diverse etiologies and prior treatments, VLNT demonstrated favorable outcomes in terms of limb circumference reduction, particularly in upper extremities. Further prospective analytic studies are warranted to validate these findings and optimize treatment protocols.