Mouchammed Agko1, Pedro Ciudad1,2, Hung-Chi Chen1. 1. Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan. 2. Department of Biological Science and Technology, China Medical University, Taichung, Taiwan.
Abstract
BACKGROUND: Both physiologic and excisional procedures have been described for the treatment of lymphedema. However, there exist few reports that combine these procedures. The objective of this study was to evaluate the effectiveness of combining vascularized lymph node transfer (VLNT) with suction-assisted lipectomy (SAL) in a staged manner for the treatment of extremity lymphedema. METHODS: Patients with unilateral late stage II lymphedema (International Society of Lymphology), who consented to staged surgical treatment, were evaluated prospectively. Between 2014 and 2015, 12 female patients with upper (n = 6) or lower (n = 6) extremity lymphedema completed the treatment protocol. Primary outcomes evaluated included limb size and number of infectious episodes. In addition, compression garment usage was analyzed. RESULTS: The overall circumference reduction rate was on average 37.9% after VLNT and increased to 96.4% after SAL. While all patients had experienced at least one infectious episode prior to surgical treatment, only one patient did so after VLNT and none after SAL. All patients were able to eventually discontinue compression therapy. CONCLUSION: VLNT followed by SAL can allow patients with late Stage II lymphedema achieve near normal limb size and eradication of infectious episodes. At follow-up, these desirable outcomes were maintained well after discontinuation of compression therapy.
BACKGROUND: Both physiologic and excisional procedures have been described for the treatment of lymphedema. However, there exist few reports that combine these procedures. The objective of this study was to evaluate the effectiveness of combining vascularized lymph node transfer (VLNT) with suction-assisted lipectomy (SAL) in a staged manner for the treatment of extremity lymphedema. METHODS:Patients with unilateral late stage II lymphedema (International Society of Lymphology), who consented to staged surgical treatment, were evaluated prospectively. Between 2014 and 2015, 12 female patients with upper (n = 6) or lower (n = 6) extremity lymphedema completed the treatment protocol. Primary outcomes evaluated included limb size and number of infectious episodes. In addition, compression garment usage was analyzed. RESULTS: The overall circumference reduction rate was on average 37.9% after VLNT and increased to 96.4% after SAL. While all patients had experienced at least one infectious episode prior to surgical treatment, only one patient did so after VLNT and none after SAL. All patients were able to eventually discontinue compression therapy. CONCLUSION: VLNT followed by SAL can allow patients with late Stage II lymphedema achieve near normal limb size and eradication of infectious episodes. At follow-up, these desirable outcomes were maintained well after discontinuation of compression therapy.
Authors: Pedro Ciudad; Oscar J Manrique; Samyd S Bustos; Mouchammed Agko; Tony Chieh-Ting Huang; Luis Vizcarra; Marco Lazo Nuñez; Federico Lo Torto; Antonio J Forte Journal: Gland Surg Date: 2020-04
Authors: Pedro Ciudad; Oscar J Manrique; Samyd S Bustos; Maria I Vargas; César Reynaga; Mouchammed Agko; Tony C T Huang; Eduardo Figueroa Benites; Horacio F Mayer; Antonio J Forte Journal: Gland Surg Date: 2020-04
Authors: Nicholas R Jarvis; Ricardo A Torres; Francisco R Avila; Antonio J Forte; Alanna M Rebecca; Chad M Teven Journal: Cancer Rep (Hoboken) Date: 2021-04-07