Pedro Ciudad1,2, Oscar J Manrique3, Samyd S Bustos3, John J P Coca1, Chang-Cheng Chang2, Pin-Keng Shih2, Fabio Nicoli4, Federico Lo Torto5, Mouchammed Agko6, Tony C-T Huang3, Michele Maruccia7, Hung-Chi Chen2. 1. Department of Plastic, Reconstructive and Burn Surgery, Arzobispo Loayza National Hospital, Lima, Peru. 2. Department of Plastic and Reconstructive Surgery, China Medical University, Taichung, Taiwan. 3. Department of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota. 4. Department of Plastic and Reconstructive Surgery, University of Rome "Tor Vergata", Rome, Italy. 5. Sapienza Università di Roma, Policlinico Umberto I, Department of Surgery "P. Valdoni", Unit of Plastic Reconstructive and Aesthetic Surgery, Rome, Italy. 6. Section of Plastic Surgery, Medical College of Georgia, Augusta University, Augusta, Georgia. 7. Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
Abstract
BACKGROUND: Vascularized lymph node transfer (VLNT) is an emerging surgical treatment for lymphedema. However, literature-comparing outcomes of upper limb lymphedema (ULL) and lower limb lymphedema (LLL) is limited. Hence, the aim of this study is to compare the long-term clinical outcomes on ULL versus LLL in patients treated with VLNT. METHODS: A retrospective study retrieving data from patients with International Society of Lymphology (ISL) stages II-III who underwent different VLNTs from July 2010 to July 2016 in our institution was performed. Demographics preoperatively, and clinical data (limb circumference, infectious episodes, lymphoscintigraphic studies) preoperatively and postoperatively were recorded. Clinical outcomes by extremity were also analyzed. RESULTS: A total of 83 patients with lymphedema (ULL: n = 30, LLL: n = 53) were included. Mean follow-up time was 32.8 months (range 24-49 months). Mean circumference reduction was higher in patients with ULL compared to with LLL (28.6 ± 8.6 vs. 22.3 ± 10.1, p < .001), and for patients with secondary lymphedema (24.8 ± 9.6, p < .001) than for patients with primary lymphedema (18.9 ± 14, p > .05). Infectious episodes per year preoperative and postoperative showed that LLL patients had higher reduction on infection rate compared with ULL patients (2.4 ± 1.1 vs. 1.9 ± 1.2, p < .001). CONCLUSION: VLNT is a promising surgical treatment option for patients with lymphedema. This study suggests that VLNT may have a more beneficial outcome in patients with ULL and with secondary lymphedema.
BACKGROUND: Vascularized lymph node transfer (VLNT) is an emerging surgical treatment for lymphedema. However, literature-comparing outcomes of upper limb lymphedema (ULL) and lower limb lymphedema (LLL) is limited. Hence, the aim of this study is to compare the long-term clinical outcomes on ULL versus LLL in patients treated with VLNT. METHODS: A retrospective study retrieving data from patients with International Society of Lymphology (ISL) stages II-III who underwent different VLNTs from July 2010 to July 2016 in our institution was performed. Demographics preoperatively, and clinical data (limb circumference, infectious episodes, lymphoscintigraphic studies) preoperatively and postoperatively were recorded. Clinical outcomes by extremity were also analyzed. RESULTS: A total of 83 patients with lymphedema (ULL: n = 30, LLL: n = 53) were included. Mean follow-up time was 32.8 months (range 24-49 months). Mean circumference reduction was higher in patients with ULL compared to with LLL (28.6 ± 8.6 vs. 22.3 ± 10.1, p < .001), and for patients with secondary lymphedema (24.8 ± 9.6, p < .001) than for patients with primary lymphedema (18.9 ± 14, p > .05). Infectious episodes per year preoperative and postoperative showed that LLL patients had higher reduction on infection rate compared with ULL patients (2.4 ± 1.1 vs. 1.9 ± 1.2, p < .001). CONCLUSION: VLNT is a promising surgical treatment option for patients with lymphedema. This study suggests that VLNT may have a more beneficial outcome in patients with ULL and with secondary lymphedema.
Authors: Pedro Ciudad; Antonio J Forte; Maria T Huayllani; Daniel Boczar; Oscar J Manrique; Samyd S Bustos; Atenas Bustamante; Hung-Chi Chen 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: Pedro Ciudad; Maria T Huayllani; Antonio J Forte; Daniel Boczar; Francisco R Avila; Joseph M Escandón; Oscar J Manrique; Hung-Chi Chen Journal: Indian J Plast Surg Date: 2022-02-28